Efficacy of minimally invasive surfactant therapy in moderate and late preterm infants: A multicentre randomized control trial

Paediatrics & Child Health
François OlivierBruno Piedboeuf

Abstract

Minimally invasive surfactant therapy (MIST) is a new strategy to avoid mechanical ventilation (MV) in respiratory distress syndrome. The primary aim of this study was to test MIST as a means of avoiding MV exposure and pneumothorax occurrence in moderate and late preterm infants (32 to 36 weeks' gestational age). This was a randomized controlled trial including three Canadian centres. Patients were randomized to standard management or to the intervention if they required nasal continuous positive airway pressure of 6 cm H2O and 35% FiO2 in the first 24 hours of life. Patients from the intervention group received MIST immediately after inclusion. The primary outcome was either need for MV or development of a pneumothorax requiring a chest tube. To ensure that clinicians were not biased toward delaying intubation in the intervention group, clinical failure criteria were also used as a primary outcome. The primary outcome was analyzed using bivariate and multivariate logistic regressions. Among 45 randomized patients, 24 were assigned to MIST and 21 to standard management. Eight infants (33%) from the intervention group met the primary outcome criteria versus 19 (90%) in the control group (absolute risk reduction 0.57, 95% confid...Continue Reading

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Citations

Sep 24, 2019·Current Pediatric Reviews·Jessie E Magnani, Steven M Donn
Jan 17, 2021·Archives of Disease in Childhood. Fetal and Neonatal Edition·Ioannis BellosAakash Pandita
Feb 9, 2021·Paediatrics & Child Health·Eugene H Ng, Vibhuti Shah
May 11, 2021·The Cochrane Database of Systematic Reviews·Mohamed E Abdel-LatifPeter A Dargaville
Aug 12, 2021·Pediatric Pulmonology·Usha Devi, Aakash Pandita
Sep 25, 2021·American Journal of Perinatology·Soume BhattacharyaOrlando da Silva
Oct 19, 2021·The Cochrane Database of Systematic Reviews·Prema SubramaniamPeter G Davis
Apr 12, 2019·Neonatology·Whittney D Barkhuff, Roger F Soll
Sep 24, 2021·Pediatrics·Venkatakrishna B KakkilayaMambarambath A Jaleel

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