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Objective: To evaluate surfactant effectiveness for the treatment of respiratory distress syndrome (RDS) in late preterm infants., Methods: We performed a retrospective cohort study of infants born between 34 +0 and 36 +6  weeks of gestation admitted for respiratory failure in seven perinatal centers from January 2010 to December 2014. We evaluated changes of FiO 2 , PaO 2 and a/APO 2 in surfactant-treated patients, and the need and duration of MV, the duration of noninvasive respiratory support, stay in NICU and in hospital in surfactant-treated and untreated late preterm infants with RDS alone., Results: We studied 562 infants with RDS, 252 (45%) were treated with surfactant and 310 (55%) were not. FiO 2 , PaO 2 and a/APO 2 significantly improved after surfactant treatment. The adjusted odds ratio for the need of MV and the adjusted differences of duration of noninvasive respiratory support, and of NICU and hospital stay were not different in the surfactant and non-surfactant groups., Conclusions: Surfactant therapy was followed by a quick and persisting significant improvement of respiratory function in late preterm infants with RDS. Surfactant did not improve short-term outcomes in our population probably because other factors such as the gestational age, occurrence of complications and poor feeding play a relevant role.

The efficacy of caffeine in an episode of Apnoea of Prematurity (AOP) has been known for over thirty years. Its use over long periods of time has not only found it to be manageable within the field of neonatology, but it has also been found to have other favourable actions, such as reducing the incidence of extubation failure, preventing Bronchopulmonary Dysplasia (BPD), reducing the need for Patent Ductus Arteriosus treatment and the beneficial effect it has on Retinopathy of Prematurity. Recent in vitro trials have highlighted the neuroprotective role that caffeine plays, which has already partly been observed from in vivo trials. Just recently, caffeine citrate has become a "label" drug and it would be beneficial if more studies could confirm the more significant effects it has on the more severe conditions of prematurity.

Unlabelled: Preterm newborns may be discharged when clinical conditions are stable and maturity of physiological functions has been gained, but no precise indications on weight and GA to be reached before discharge are available. In our NICU we have observed in the last five years 234 newborns < 32 weeks of GA; we have decided to transfer from incubators at the mean weight of 1737 g, regardless of their GA and birth weight and to discharge at a mean weight of 1966 g, the lowest mean weight in comparison to the other twelve NICUs of the Lazio region. We have analyzed if the major diseases affecting those newborns (RDS, mechanical ventilation, PDA, IVH/PVL, PHH, NEC, ROP, sepsis ) have influenced weight at discharge in 13 NICUs of Lazio region., Conclusions: in our NICU the discharge of ELBW/VLBW preterm newborns < 32 weeks GA and/or < 1500 g can be feasible at a mean weight close to 1900 g. An early transfer from incubator at a mean weight of 1737 g promotes an early discharge from hospital. Major diseases affecting those newborn haven't influenced weight at discharge.

The late-preterm infants are a group of premature steadily increasing, different from term infants as immature in terms of respiratory, metabolic, neurological, and immunological features. They may present at birth and during the first week of life various diseases and brain lesions echographically evident. We analyzed the neonatal outcomes of 417 late-preterm infants, born in our Department of Neonatology in a period of two and a half years, evaluating respiratory problems (RDS, transient tachypnea, pneumonia, pneumothorax, and apnea), metabolic problems (hypoglycemia, hypomagnesemia, hypo-hypernatremia, dehydration, hypocalcemia, and hyperbilirubinemia), infections, neurological symptoms associated with electrolyte disturbances, the disease patterns observed by ultrasound examination of the brain, the kidney ultrasound images, genital malformations.