Comparison of the Efficacy of Intubation-Surfactant-Extubation and Less-Invasive Surfactant Administration Techniques in Preterm Neonates With Respiratory Distress Syndrome
Onkar Prasad Khandwal, Shashikant Dewangan, Deepak Kumar
Abstract
Background and Aim: Respiratory failure, a frequent cause of preterm neonatal mortality, is mainly due to respiratory distress syndrome (RDS). Respiratory assistance and exogenous surfactant replacement therapy are the usual modes of treatment adopted. This study aimed to compare the efficacy of intubation-surfactant-extubation (INSURE) and less-invasive surfactant administration (LISA) in preterm neonates with RDS.
Materials and Methods: This prospective, comparative study enrolled preterm neonates born between 28 and 34 weeks of gestation, diagnosed with RDS, and admitted to the NICU. The neonates were randomized into LISA and INSURE groups, and the respective treatments were administered. The clinical outcomes between the groups were compared primarily based on the duration of respiratory support and the incidence of sepsis.
Results: The mean duration of mechanical ventilation and continuous positive airway pressure (CPAP) were more in the INSURE group than in the LISA group (3.57 vs 2.54 d and 4.57 vs 3.54 d, respectively; P = .013). The incidence rate of sepsis was high in the INSURE group than in the LISA group (54 [77.1%] vs 39 [55.7%]; P = .007). There was no difference in duration of NICU stay in the study groups.
Conclusion: LISA was more advantageous in terms of the duration of mechanical ventilation and CPAP and incidence of sepsis compared with INSURE. Hence, LISA was found to be better than INSURE in our scenario.
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