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Acta Paediatr. 2019 Jul 16. doi: 10.1111/apa.14939. [Epub ahead of print]

The effect of less invasive surfactant administration on cerebral oxygenation in preterm infants.

Author information

1
Department of Pediatrics, University of Lübeck, Lübeck, Germany.
2
Institute for Medical Biometry and Statistics, University of Lübeck, Lübeck, Germany.
3
Department of Neonatology, Klinikum Aschaffenburg-Alzenau, Aschaffenburg, Germany.

Abstract

AIM:

To determine the regional cerebral tissue oxygenation saturation (rcSO2 ) in a group of infants requiring less invasive surfactant administration (LISA) as compared to infants with continuous positive airway pressure (CPAP) only.

METHODS:

In preterm infants with a gestational age 26 0/7-31 6/7 weeks, we conducted an observational study using near-infrared spectroscopy (NIRS) in the first 120 hours of life.

RESULTS:

We analysed the data of 22 infants who never received surfactant (CPAP), 22 infants had LISA and CPAP (LISA) and 6 infants received surfactant via endotracheal tube (ETT). Four infants had both surfactant application modes including six LISA applications. In total, there were 32 successful LISA applications but 44 attempts; 13/44 (30%) of LISA attempts resulted in a 20% decrease of rcSO2 . During the first 120 hours of life, rcSO2 values of CPAP were similar to those of infants in the LISA group, that is median rcSO2 values 90% vs 85%, respectively (P = .126). Episodes with rcSO2 values <65% were 0.4% in the CPAP group as compared to 4.8% in the LISA group (P < .001).

CONCLUSION:

Our observational data indicate that rcSO2 values of infants in the LISA group were similar to the CPAP group.

KEYWORDS:

cerebral oxygenation saturation; less invasive surfactant administration; near-infrared spectroscopy; preterm infants

PMID:
31310677
DOI:
10.1111/apa.14939

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