Lung recruitment before surfactant administration in extremely preterm neonates with respiratory distress syndrome (IN-REC-SUR-E): a randomised, unblinded, controlled trial.

The Lancet. Respiratory Medicine
Giovanni VentoJ Jane Pillow

Abstract

The importance of lung recruitment before surfactant administration has been shown in animal studies. Well designed trials in preterm infants are absent. We aimed to examine whether the application of a recruitment manoeuvre just before surfactant administration, followed by rapid extubation (intubate-recruit-surfactant-extubate [IN-REC-SUR-E]), decreased the need for mechanical ventilation during the first 72 h of life compared with no recruitment manoeuvre (ie, intubate-surfactant-extubate [IN-SUR-E]). We did a randomised, unblinded, controlled trial in 35 tertiary neonatal intensive care units in Italy. Spontaneously breathing extremely preterm neonates (24 + 0 to 27 + 6 weeks' gestation) reaching failure criteria for continuous positive airway pressure within the first 24 h of life were randomly assigned (1:1) with a minimisation algorithm to IN-REC-SUR-E or IN-SUR-E using an interactive web-based electronic system, stratified by clinical site and gestational age. The primary outcome was the need for mechanical ventilation in the first 72 h of life. Analyses were done in intention-to-treat and per-protocol populations, with a log-binomial regression model correcting for stratification factors to estimate adjusted relative r...Continue Reading

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Citations

Jul 21, 2020·The Lancet. Respiratory Medicine·Neil N Finer, Anup Katheria
Feb 6, 2021·The Lancet. Respiratory Medicine·Giovanni Vento, UNKNOWN IN-REC-SUR-E Study Group
Mar 30, 2021·The Cochrane Database of Systematic Reviews·Elizabeth V BlazekJudith Hough
Feb 6, 2021·The Lancet. Respiratory Medicine·Vasantha H S Kumar
May 1, 2021·Children·Tobias MuehlbacherManuel B Bryant
May 12, 2021·Acta Paediatrica·Giovanni Vento, UNKNOWN IN-REC-SUR-E Study Group
Jun 22, 2021·Journal of Neonatal-perinatal Medicine·M PierroR Copetti
Aug 20, 2021·Pediatric Health, Medicine and Therapeutics·Marissa HennellySamia Aleem

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