Less invasive surfactant administration and complications of preterm birth

被引：65

作者：

Haertel, Christoph ^{[1
]}

Paul, Pia ^{[1
]}

Hanke, Kathrin ^{[1
]}

Humberg, Alexander ^{[1
]}

Kribs, Angela ^{[2
]}

Mehler, Katrin ^{[2
]}

Vochem, Matthias ^{[3
]}

Wieg, Christian ^{[4
]}

Roll, Claudia ^{[5
]}

Herting, Egbert ^{[1
]}

Goepel, Wolfgang ^{[1
]}

机构：

[1] Univ Lubeck, Dept Pediat, Lubeck, Germany

[2] Univ Cologne, Dept Neonatol, Cologne, Germany

[3] Olga Hosp Stuttgart, Dept Neonatol, Stuttgart, Germany

[4] Klinikum Aschaffenburg, Dept Neonatol, Aschaffenburg, Germany

[5] Univ Witten Herdecke, Vest Childrens Hosp Datteln, Dept Neonatol, Witten, Germany

来源：

SCIENTIFIC REPORTS | 2018年 / 8卷

关键词：

SPONTANEOUS INTESTINAL PERFORATION; WEIGHT INFANTS; NEURODEVELOPMENTAL OUTCOMES; NECROTIZING ENTEROCOLITIS; THERAPY; ASSOCIATION; VENTILATION; MORTALITY; GERMANY;

D O I：

10.1038/s41598-018-26437-x

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

In a large cohort study of the German Neonatal Network (GNN) we aimed to evaluate whether less invasive surfactant administration (LISA) strategy is associated with complications of preterm birth. Within the observational period n = 7533 very-low-birth-weight infants (VLBWI) with gestational age 22 0/7 to 28 6/7 weeks were enrolled in GNN; n = 1214 VLBWI never received surfactant, n = 2624 VLBWI were treated according to LISA procedure, n = 3695 VLBWI had surfactant via endotracheal tube (ETT). LISA was associated with a reduced risk for adverse outcome measures including mortality [odds ratio (OR) 0.66 (95% CI: 0.51-0.84), p < 0.001] bronchopulmonary dysplasia [BPD; OR 0.55 (95% CI: 0.49-0.62), p < 0.001], intracerebral hemorrhage (ICH) grade II-IV [OR 0.55 (95% CI: 0.48-0.64), p < 0.001] and retinopathy of prematurity [ROP; OR 0.62 (95% CI: 0.45-0.85), p < 0.001]. Notably, LISA was associated with an increased risk for focal intestinal perforation [FIP; OR 1.49 (95% CI: 1.14-1.95), p = 0.002]. The differences in FIP rates were primarily observed in VLBWI born < 26 weeks (LISA: 10.0 vs. ETT: 7.4%, p = 0.029). Our observational data confirm that LISA is associated with improved outcome. In infants < 26 weeks we noted an increased risk for FIP. Future randomized controlled trials including LISA need to integrate safety analyses for this particular subgroup.

引用

页数：7

共 27 条

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