Is Less Invasive Surfactant Administration a Beneficial Method for Late Preterm Infants?

Late preterm infants (LPIs) have increased steadily in all newborns delivery and they are the largest patient group requiring admission to the neonatal intensive care unit. Surfactant treatment is frequently used in LPIs in case of respiratory distress, but the procedure and the timing of surfactant administration are not well-known.

We aimed to evaluate the effect of surfactant administration techniques on pulmonary outcomes in LPIs with respiratory distress.

In this retrospective study, we compared the effects of the less invasive surfactant administration (LISA) technique and conventional treatment on respiratory and other morbidities in LPIs who have respiratory difficulties. We named these two groups as the LISA group and the conventional group (CG). Comparison of the mechanical ventilation (MV) rates between the groups was the primary outcome of our study.

There were 25 LPIs in each group. The duration of nasal continuous positive airway pressure (CPAP) and oxygenation were similar in both groups. The rate of MV and the duration of MV (P=0.004 and P=0.02) were lower in the LISA group. Also, the need for more than 1 dose of surfactant was higher in the MV requiring group, although it was not statistically significant between the groups (P=0.21).

Using the LISA technique for surfactant instillation reduces any MV requirement. LISA is a very useful and reliable technique in experienced hands in LPIs as in very preterm infants.