1. Minimally invasive surfactant therapy failure: Risk factors and outcome
- Author
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Peter Andriessen, J. Dieleman, Hendrik J. Niemarkt, Lobke C. E. Janssen, Anton H. van Kaam, Jooske van der Spil, Wes Onland, School of Med. Physics and Eng. Eindhoven, Neonatology, and ARD - Amsterdam Reproduction and Development
- Subjects
Male ,Time Factors ,medicine.medical_treatment ,Body Temperature ,Adrenal Cortex Hormones ,Risk Factors ,Neonatal ,Continuous positive airway pressure ,Netherlands ,Respiratory Distress Syndrome ,Continuous Positive Airway Pressure ,Respiratory distress ,Obstetrics and Gynecology ,Gestational age ,General Medicine ,Intensive Care Units ,C-Reactive Protein ,Infant, Extremely Premature ,Female ,Drug ,Infant, Premature ,medicine.drug ,medicine.medical_specialty ,Respiratory Distress Syndrome, Newborn/therapy ,surfactant ,Gestational Age ,Extremely Premature ,Surfactant therapy ,Dose-Response Relationship ,C-Reactive Protein/analysis ,Adrenal Cortex Hormones/administration & dosage ,Intensive care ,Intensive Care Units, Neonatal ,medicine ,otorhinolaryngologic diseases ,Poractant alfa ,Humans ,Newborn/therapy ,Pulmonary Surfactants/administration & dosage ,Premature ,Retrospective Studies ,Mechanical ventilation ,Respiratory Distress Syndrome, Newborn ,Dose-Response Relationship, Drug ,business.industry ,Infant, Newborn ,Infant ,Pulmonary Surfactants ,Retrospective cohort study ,Newborn ,respiratory ,Logistic Models ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,business ,preterm ,Continuous Positive Airway Pressure/methods - Abstract
ObjectiveTo evaluate incidence of minimally invasive surfactant therapy (MIST) failure, identify risk factors and assess the impact of MIST failure on neonatal outcome.DesignRetrospective cohort study. MIST failure was defined as need for early mechanical ventilation (SettingTwo tertiary neonatal intensive care centres in the Netherlands.PatientsInfants born between 24 weeks’ and 31 weeks’ gestational age (GA) (n=185) with MIST for respiratory distress syndrome.InterventionsMIST procedure with poractant alfa (100–200 mg/kg).Main outcome measuresContinuous positive airway pressure (CPAP) failure after MIST in the first 72 hours of life.Results30% of the infants failed CPAP after MIST. In a multivariate logistic regression analysis, four risk factors were independently associated with failure: GA Furthermore, MIST failure was independently associated with an increased risk of severe intraventricular haemorrhage.ConclusionWe observed moderate MIST failure rates in concordance with the results of earlier studies. Absence of corticosteroids and lower surfactant dose are risk factors for MIST failure that may be modifiable in order to improve MIST success and patient outcome.
- Published
- 2019