Short-Term Outcomes of Implementing Less Invasive Surfactant Therapy in Infants Born Less than 30 Weeks: A...

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology
• Critical Care

Background:

• Less invasive surfactant administration (LISA) is a technique for delivering surfactant to preterm infants.
• Evaluating the real-world impact of LISA implementation on clinical outcomes is crucial for neonatal care guidelines.

Purpose of the Study:

• To assess the effect of implementing less invasive surfactant (LISA) therapy on short-term clinical outcomes in extremely preterm infants (<30 weeks gestational age).

Main Methods:

• Retrospective cohort study of 725 infants born <30 weeks gestational age (GA) between 2009-2023.
• Comparison of outcomes between a pre-LISA epoch (2009-2012) and a fully implemented LISA epoch (2018-2023).
• Primary outcome: death or moderate/severe bronchopulmonary dysplasia (BPD) at 36 weeks postmenstrual age, analyzed using time trend and multivariable regression.

Main Results:

• LISA use increased from 0% to 83.0% over the study period.
• No significant reduction in the composite outcome of death or BPD with LISA implementation (aOR 0.88).
• A significant reduction in mortality was observed in the LISA epoch compared to the pre-LISA epoch (aOR 0.62).

Conclusions:

• LISA implementation is feasible in clinical practice and may improve survival in preterm infants.
• LISA was not associated with a reduction in the combined outcome of death or BPD.
• Further research is needed to evaluate the long-term effects of LISA therapy.