The minimal invasive surfactant therapy: experience from a low resource setting

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology
• Critical Care

Background:

• Respiratory distress syndrome (RDS) is a significant cause of mortality in preterm infants, particularly in sub-Saharan Africa.
• Surfactant replacement therapy (SRT) is underutilized, and Minimal Invasive Surfactant Therapy (MIST) is a novel approach recently introduced in Asaba, Nigeria.

Purpose of the Study:

• To evaluate the effectiveness of Minimal Invasive Surfactant Therapy (MIST) in managing neonatal respiratory distress.
• To assess the impact of MIST on clinical outcomes in preterm newborns.

Main Methods:

• A descriptive survey was conducted on newborns receiving MIST, nasal bubble Continuous Positive Airway Pressure (n b-CPAP), and supportive care.
• Data collected included demographic characteristics, gestational age, birth weight, and treatment parameters over a one-year period.

Main Results:

• MIST was administered to 51 infants (48 preterm, 3 term) with RDS, perinatal asphyxia, or meconium aspiration syndrome.
• The therapy was successful in 92.2% of cases, with significant improvements noted in respiratory distress severity scores.
• The mortality rate was 23.5%, with deaths occurring at various intervals post-treatment.

Conclusions:

• Minimal Invasive Surfactant Therapy (MIST) shows promise in improving outcomes for extremely preterm infants at FMC Asaba.
• Financial constraints present a significant challenge to the widespread implementation of MIST.