RETREATMENT WITH SURFACTANT IN VERY LOW BIRTH WEIGHT PRETERM INFANTS: RISK PREDICTORS AND THEIR INFLUENCE ON NEONATAL OUTCOMES

Objective: To assess clinical predictors and outcomes associated to the need for surfactant retreatment in preterm infants. Methods: Retrospective cohort study, including very low birth weight preterm infants from January 2006 to December 2015 who underwent surfactant replacement therapy. Beractant was used (100 mg/kg), repeated every six hours if FiO(2) >= 0.40. The subjects were classified into two groups: single surfactant dose; and more than one dose (retreatment). We evaluated maternal and neonatal predictors for the need of retreatment and neonatal outcomes associated to retreatment. Results: A total of 605 patients (44.5%) received surfactant; 410 (67.8%) one dose, and 195 (32.2%) more than one dose: 163 (83.5%) two doses and 32 (16.4%) three doses. We could not find clinical predictors for surfactant retreatment. Retreatment was associated to a greater chance of BPD in infants >1000 g (RR 1.78; 95% CI 1.30-2.45) and <= 1000 g (RR 1.33; 95% CI 1.04-1.70), in infants with gestational age<28 weeks (RR 1.56; 95%CI 1.12-2.18) and >= 28 weeks (RR 1.50; 95%CI 1.17-1.92), in neonates with early sepsis (RR 1.48; 95% CI 1.20-1.81), and in infants not exposed to antenatal corticosteroids (RR 1.62; 95%CI 1.20-2.17) Conclusions: We could not find predictor factors associated to surfactant retreatment. The need for two or more doses of surfactant was significantly related to bronchopulmonary dysplasia.