Outcomes following less-invasive-surfactant-administration in the delivery-room

Fahad M.S. Arattu Thodika; Hemant Ambulkar; Emma Williams; Ravindra Bhat; Theodore Dassios; Anne Greenough

doi:10.1016/j.earlhumdev.2022.105562

Outcomes following less-invasive-surfactant-administration in the delivery-room

Fahad M.S. Arattu Thodika, Hemant Ambulkar, Emma Williams, Ravindra Bhat, Theodore Dassios, Anne Greenough^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

Background: Less invasive surfactant administration (LISA) on the neonatal unit reduces the need for mechanical ventilation and bronchopulmonary dysplasia (BPD). Aims: To assess the immediate and longer-term efficacy of LISA to prematurely born infants in the delivery-room. Study design: A case control study with inborn historical controls matched for gestational age, birthweight and gender to each LISA infant. Subjects: Infants born between 26⁺⁰ weeks and 34⁺⁶ weeks of gestational age. Outcome measures: Respiratory function monitoring before and after LISA and need for mechanical ventilation within 72 h of birth. Results: Ninety-nine infants, median gestational age of 32⁺⁴(range:27⁺⁰–34⁺⁶) weeks, were prospectively recruited. The respiratory rate and inspired oxygen (FiO₂) decreased two minutes after LISA and there was a reduction in the FiO₂ requirement at two hours post birth. Compared to historical controls, LISA administration was associated with a reduction in the need for mechanical ventilation within 72 h after birth (20.2% versus 56.6% p < 0.001) the incidence of moderate to severe BPD (8.2% versus 20.2%, p = 0.02) and the median costs of neonatal intensive care stay (£1218 versus £2436, p = 0.03) and total neonatal unit stay (£12,888 versus £17,240, p = 0.04). A high FiO₂ in the delivery-room pre-LISA (median 0.75 versus 0.60, p = 0.02) was associated with LISA failure, that is mechanical ventilation within 72 h of birth. Conclusions: LISA to prematurely born infants in the delivery-room was associated with reductions in the need for mechanical ventilation and costs of care, but was less successful in those with initial, more severe respiratory disease.

Original language	English
Article number	105562
Journal	Early Human Development
Volume	167
Early online date	26 Feb 2022
DOIs	https://doi.org/10.1016/j.earlhumdev.2022.105562
Publication status	Published - Apr 2022

Keywords

Healthcare cost
LISA
LISA failure
Respiratory function monitor

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10.1016/j.earlhumdev.2022.105562

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@article{31612af94d7d487ba1a3d1e0f9b1dfd5,

title = "Outcomes following less-invasive-surfactant-administration in the delivery-room",

abstract = "Background: Less invasive surfactant administration (LISA) on the neonatal unit reduces the need for mechanical ventilation and bronchopulmonary dysplasia (BPD). Aims: To assess the immediate and longer-term efficacy of LISA to prematurely born infants in the delivery-room. Study design: A case control study with inborn historical controls matched for gestational age, birthweight and gender to each LISA infant. Subjects: Infants born between 26+0 weeks and 34+6 weeks of gestational age. Outcome measures: Respiratory function monitoring before and after LISA and need for mechanical ventilation within 72 h of birth. Results: Ninety-nine infants, median gestational age of 32+4(range:27+0–34+6) weeks, were prospectively recruited. The respiratory rate and inspired oxygen (FiO2) decreased two minutes after LISA and there was a reduction in the FiO2 requirement at two hours post birth. Compared to historical controls, LISA administration was associated with a reduction in the need for mechanical ventilation within 72 h after birth (20.2% versus 56.6% p < 0.001) the incidence of moderate to severe BPD (8.2% versus 20.2%, p = 0.02) and the median costs of neonatal intensive care stay (£1218 versus £2436, p = 0.03) and total neonatal unit stay (£12,888 versus £17,240, p = 0.04). A high FiO2 in the delivery-room pre-LISA (median 0.75 versus 0.60, p = 0.02) was associated with LISA failure, that is mechanical ventilation within 72 h of birth. Conclusions: LISA to prematurely born infants in the delivery-room was associated with reductions in the need for mechanical ventilation and costs of care, but was less successful in those with initial, more severe respiratory disease.",

keywords = "Healthcare cost, LISA, LISA failure, Respiratory function monitor",

author = "{Arattu Thodika}, {Fahad M.S.} and Hemant Ambulkar and Emma Williams and Ravindra Bhat and Theodore Dassios and Anne Greenough",

note = "Funding Information: The research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Chiesi funded this study, but were not involved in its design, performance or analysis. EEW was supported by the Charles Wolfson Charitable Trust and additionally by SLE. Publisher Copyright: {\textcopyright} 2022 Elsevier B.V.",

year = "2022",

month = apr,

doi = "10.1016/j.earlhumdev.2022.105562",

language = "English",

volume = "167",

journal = "Early Human Development",

issn = "0378-3782",

publisher = "Elsevier Ireland Ltd",

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T1 - Outcomes following less-invasive-surfactant-administration in the delivery-room

AU - Arattu Thodika, Fahad M.S.

AU - Ambulkar, Hemant

AU - Williams, Emma

AU - Bhat, Ravindra

AU - Dassios, Theodore

AU - Greenough, Anne

N1 - Funding Information: The research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Chiesi funded this study, but were not involved in its design, performance or analysis. EEW was supported by the Charles Wolfson Charitable Trust and additionally by SLE. Publisher Copyright: © 2022 Elsevier B.V.

PY - 2022/4

Y1 - 2022/4

N2 - Background: Less invasive surfactant administration (LISA) on the neonatal unit reduces the need for mechanical ventilation and bronchopulmonary dysplasia (BPD). Aims: To assess the immediate and longer-term efficacy of LISA to prematurely born infants in the delivery-room. Study design: A case control study with inborn historical controls matched for gestational age, birthweight and gender to each LISA infant. Subjects: Infants born between 26+0 weeks and 34+6 weeks of gestational age. Outcome measures: Respiratory function monitoring before and after LISA and need for mechanical ventilation within 72 h of birth. Results: Ninety-nine infants, median gestational age of 32+4(range:27+0–34+6) weeks, were prospectively recruited. The respiratory rate and inspired oxygen (FiO2) decreased two minutes after LISA and there was a reduction in the FiO2 requirement at two hours post birth. Compared to historical controls, LISA administration was associated with a reduction in the need for mechanical ventilation within 72 h after birth (20.2% versus 56.6% p < 0.001) the incidence of moderate to severe BPD (8.2% versus 20.2%, p = 0.02) and the median costs of neonatal intensive care stay (£1218 versus £2436, p = 0.03) and total neonatal unit stay (£12,888 versus £17,240, p = 0.04). A high FiO2 in the delivery-room pre-LISA (median 0.75 versus 0.60, p = 0.02) was associated with LISA failure, that is mechanical ventilation within 72 h of birth. Conclusions: LISA to prematurely born infants in the delivery-room was associated with reductions in the need for mechanical ventilation and costs of care, but was less successful in those with initial, more severe respiratory disease.

AB - Background: Less invasive surfactant administration (LISA) on the neonatal unit reduces the need for mechanical ventilation and bronchopulmonary dysplasia (BPD). Aims: To assess the immediate and longer-term efficacy of LISA to prematurely born infants in the delivery-room. Study design: A case control study with inborn historical controls matched for gestational age, birthweight and gender to each LISA infant. Subjects: Infants born between 26+0 weeks and 34+6 weeks of gestational age. Outcome measures: Respiratory function monitoring before and after LISA and need for mechanical ventilation within 72 h of birth. Results: Ninety-nine infants, median gestational age of 32+4(range:27+0–34+6) weeks, were prospectively recruited. The respiratory rate and inspired oxygen (FiO2) decreased two minutes after LISA and there was a reduction in the FiO2 requirement at two hours post birth. Compared to historical controls, LISA administration was associated with a reduction in the need for mechanical ventilation within 72 h after birth (20.2% versus 56.6% p < 0.001) the incidence of moderate to severe BPD (8.2% versus 20.2%, p = 0.02) and the median costs of neonatal intensive care stay (£1218 versus £2436, p = 0.03) and total neonatal unit stay (£12,888 versus £17,240, p = 0.04). A high FiO2 in the delivery-room pre-LISA (median 0.75 versus 0.60, p = 0.02) was associated with LISA failure, that is mechanical ventilation within 72 h of birth. Conclusions: LISA to prematurely born infants in the delivery-room was associated with reductions in the need for mechanical ventilation and costs of care, but was less successful in those with initial, more severe respiratory disease.

KW - Healthcare cost

KW - LISA

KW - LISA failure

KW - Respiratory function monitor

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U2 - 10.1016/j.earlhumdev.2022.105562

DO - 10.1016/j.earlhumdev.2022.105562

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SN - 0378-3782

VL - 167

JO - Early Human Development

JF - Early Human Development

M1 - 105562

ER -

Outcomes following less-invasive-surfactant-administration in the delivery-room

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Keywords

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