Effectiveness of A Respiratory Care Protocol Including Less Invasive Surfactant Administration in ≥ 35 Weeks...

Area of Science:

• Neonatal Medicine
• Respiratory Care
• Pediatric Pulmonology

Background:

• A respiratory care protocol (RCP) incorporating less invasive surfactant administration (LISA) was introduced in October 2018 for preterm infants on continuous positive airway pressure (CPAP).
• This study evaluates changes in respiratory care practices and outcomes following the RCP implementation.

Purpose of the Study:

• To compare respiratory care practices and clinical outcomes in infants ≥35 weeks gestational age before and after the introduction of an RCP.
• To assess the impact of the RCP on surfactant use, oxygen requirements, and respiratory severity.

Main Methods:

• A retrospective cohort study comparing infants from January 2016-September 2018 (pre-RCP) and October 2018-December 2021 (post-RCP).
• Infants ≥35 weeks gestational age requiring <24 hours of CPAP and without meconium aspiration syndrome were included.
• Respiratory support, surfactant administration, oxygenation, and clinical outcomes were analyzed.

Main Results:

• The post-RCP cohort showed increased surfactant therapy use (8% vs 22%, p<0.001) compared to the pre-RCP cohort.
• Surfactant therapy in the post-RCP group was associated with reduced FiO2 requirements and lower respiratory severity scores.
• No significant differences were observed in the need for mechanical ventilation, pneumothorax incidence, or hospital length of stay between the two cohorts.

Conclusions:

• Implementation of the RCP led to increased surfactant use and improved oxygenation parameters in infants ≥35 weeks GA.
• Despite improved oxygenation, the RCP did not significantly alter major clinical outcomes.
• Further investigation is warranted to determine the specific role and efficacy of LISA in this patient population.