Safety of synthetic surfactant use before preterm newborn transport

The benefit of surfactant administration in preterm newborns is well described. The increase in lung compliance and other effects that it produces might however be dangerous in a transportation situation. This study examined the safety of surfactant (primarily Exosurf; Burroughs-Wellcome Research, Triangle Park, NC, USA) administration in preterm babies prior to their transportation from a peripheral hospital to a tertiary Neonatal Intensive Care Unit.

Two groups of babies were examined retrospectively over a 4-year period. One group, designated C (n = 46), received surfactant prior to transport and the other, designated Z (n = 85), did not.

There was no significant difference in morbidity or mortality between the groups. The benefits of early surfactant were reinforced in Group C with fewer days ventilated while having no significant change in days on continuous positive airways pressure, in oxygen or days before discharge. During transport, mean airway pressure was unchanged but group C had a significantly greater drop in oxygen requirement. In those less than 30 weeks gestation, increased respiratory benefit was apparent in those who received pretransport surfactant.

Administration of synthetic surfactant prior to preterm newborn transportation is safe with no intra-transport complications.