Effects of surfactant treatment in late preterm infants with respiratory distress syndrome

Abstract

Objective: To evaluate surfactant effectiveness for the treatment of respiratory distress syndrome (RDS) in late preterm infants.

Methods: We performed a retrospective cohort study of infants born between 34⁺⁰ and 36⁺⁶ weeks of gestation admitted for respiratory failure in seven perinatal centers from January 2010 to December 2014. We evaluated changes of FiO₂, PaO₂ and a/APO₂ in surfactant-treated patients, and the need and duration of MV, the duration of noninvasive respiratory support, stay in NICU and in hospital in surfactant-treated and untreated late preterm infants with RDS alone.

Results: We studied 562 infants with RDS, 252 (45%) were treated with surfactant and 310 (55%) were not. FiO₂, PaO₂ and a/APO₂ significantly improved after surfactant treatment. The adjusted odds ratio for the need of MV and the adjusted differences of duration of noninvasive respiratory support, and of NICU and hospital stay were not different in the surfactant and non-surfactant groups.

Conclusions: Surfactant therapy was followed by a quick and persisting significant improvement of respiratory function in late preterm infants with RDS. Surfactant did not improve short-term outcomes in our population probably because other factors such as the gestational age, occurrence of complications and poor feeding play a relevant role.

Keywords:

• Late preterm
• surfactant
• respiratory distress syndrome
• infant

Acknowledgements

Collaborators of the study: The following hospitals and investigators participated to this study, with study sites listed in according to the number of infants they enrolled: NICU, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy: Mariarosa Colnaghi, Valentina Condò; Division of Neonatology, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy: Alessandra Lio, Cinzia Ricci, Chiara Tirone; Neonatology and Neonatal Intensive Care Unit, MBBM Foundation, Monza, Italy: Maria Luisa Ventura, Alessia Di Marco; Division of Neonatology, Department of Neurosciences, Psychology, Drug Research and Child Health, Careggi University Hospital of Florence, Italy: Maria Laura Marzi; Department of Maternal and Child Health, Division of Neonatology and Neonatal Intensive Care, Casilino General Hospital, ASL RM B, Roma, Italy: Piermichele Paolillo; Division of Neonatology, “V. Buzzi” Children’s Hospital – ASST FBF/Sacco, Milan, Italy: Sara Gatto, Enrica Lupo; Neonatal Intensive Care Unit, Institute of Puericulture and Neonatal Section, Department of Surgery, University of Cagliari, Cagliari, Italy: Roberta Irmesi.

Disclosure statement

Carlo Dani, Fabio Mosca, and Paolo Tagliabue have served as consultants to Chiesi on an unrelated topic. The other authors have indicated they have no financial relationships relevant to this article to disclose.

Additional information

Funding

The study was partially funded by Chiesi Farmaceutici (Parma, Italy), but this company had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript.