MIST versus INSURE: Superior outcomes in surfactant administration for preterm neonates with RDS

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology
• Critical Care

Background:

• Respiratory distress syndrome (RDS) is a common condition in preterm infants.
• The Intubation-Surfactant-Extubation (INSURE) method is a standard treatment for RDS.
• Minimally invasive surfactant therapy (MIST) offers a less invasive alternative to INSURE.

Purpose of the Study:

• To compare the complications and outcomes of MIST versus INSURE in preterm infants with RDS.
• To evaluate the efficacy and safety of MIST as a surfactant delivery method.

Main Methods:

• Retrospective analysis of 513 preterm infants (28-34 weeks gestational age) with RDS.
• Comparison of outcomes between infants treated with INSURE (n=257) and MIST (n=256).
• Data collected included gestational age, birth weight, Apgar scores, mechanical ventilation, oxygen therapy duration, and surfactant re-dosing.

Main Results:

• No significant difference in mortality between MIST and INSURE groups.
• MIST group showed significantly lower rates of mechanical ventilation duration (P = 0.0001).
• MIST group had significantly lower incidences of retinopathy of prematurity (ROP; P = 0.026) and sepsis (P = 0.010).

Conclusions:

• MIST is a safe and effective alternative to INSURE for surfactant administration in preterm infants with RDS.
• MIST is associated with improved short-term outcomes, including reduced mechanical ventilation and lower ROP and sepsis rates.
• MIST is a preferable approach in clinical practice for managing RDS in preterm infants.