Association of Adherence to Surfactant Best Practice Uses With Clinical Outcomes Among Neonates in Sweden

Key Points Question What strategies for surfactant treatment of newborn infants are used, and how are these strategies associated with outcomes? Findings In this cohort study of 5209 infants who received 7980 surfactant administrations, late surfactant treatment (>2 hours after birth) was provided for 39% of very preterm infants and associated with higher neonatal morbidity. Off-label use occurred in 19% of infants without any association to outcome, and treatment omissions were associated with lower survival. Meaning In this study, adherence to best practices for surfactant use in newborn infants varied, with important clinical implications for neonatal outcomes.
This cohort study evaluates registered use, off-label use, and omissions of surfactant treatment by gestational age and associations with outcomes, mainly among very preterm infants (gestational age
Importance While surfactant therapy for respiratory distress syndrome (RDS) in preterm infants has been evaluated in clinical trials, less is known about how surfactant is used outside such a framework. Objective To evaluate registered use, off-label use, and omissions of surfactant treatment by gestational age (GA) and associations with outcomes, mainly among very preterm infants (GA