Surfactant therapy in late preterm and term neonates with respiratory distress syndrome: a systematic review and meta-analysis.

Arch Dis Child Fetal Neonatal Ed

Nuffield Department of Population Health, Medical Sciences Division, National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK

Published: July 2022

Background: There are no evidence-based recommendations for surfactant use in late preterm (LPT) and term infants with respiratory distress syndrome (RDS).

Objective: To investigate the safety and efficacy of surfactant in LPT and term infants with RDS.

Methods: Systematic review, meta-analysis and evidence grading.

Interventions: Surfactant therapy versus standard of care.

Main Outcome Measures: Mortality and requirement for invasive mechanical ventilation (IMV).

Results: Of the 7970 titles and abstracts screened, 17 studies (16 observational studies and 1 randomised controlled trial (RCT)) were included. Of the LPT and term neonates with RDS, 46% (95% CI 40% to 51%) were treated with surfactant. We found moderate certainty of evidence (CoE) from observational studies evaluating infants supported with non-invasive respiratory support (NRS) or IMV that surfactant use may be associated with a decreased risk of mortality (OR 0.45, 95% CI 0.32 to 0.64). Very low CoE from observational trials in which surfactant was administered at FiO >0.30-0.40 to infants on Continuous Positive Airway Pressure (CPAP) indicated that surfactant did not decrease the risk of IMV (OR 1.20, 95% CI 0.40 to 3.56). Very low to low CoE from the RCT and observational trials showed that surfactant use was associated with a significant decrease in risk of air leak, persistent pulmonary hypertension of the newborn (PPHN), duration of IMV, NRS and hospital stay.

Conclusions: Current evidence base on surfactant therapy in LPT and term infants with RDS indicates a potentially decreased risk of mortality, air leak, PPHN and duration of respiratory support. In view of the low to very low CoE and widely varying thresholds for deciding on surfactant replacement in the included studies, further trials are needed.

Download full-text PDF

Source
http://dx.doi.org/10.1136/archdischild-2021-322890DOI Listing

Publication Analysis

Top Keywords

lpt term
16
surfactant therapy
12
term infants
12
low coe
12
surfactant
11
late preterm
8
term neonates
8
respiratory distress
8
distress syndrome
8
systematic review
8

Similar Publications

Aim: To determine how gestational age at birth and postnatal growth relate to body composition in childhood.

Methods: We calculated conditional growth (birth-2 years, 2 years-6 years) and measured body composition at 2 and 6 years using bioelectrical impedance in cohorts of New Zealand children born very preterm (VPT; 23-31 weeks), late preterm (LPT; 35- <37 weeks) and term (≥37 weeks). We explored the relationships between growth and fat mass (FM) index and fat-free mass (FFM) index at 6 years using multivariable linear regression.

View Article and Find Full Text PDF

Impact of the long-term storage on flavor quality of Liupao tea using sensory evaluation combined with metabolomics analysis.

Food Res Int

December 2024

College of Chemistry and Bioengineering, Guilin University of Technology, Guilin 541004, China; Guangxi Field Scientific Observation and Research Station for Tea Resources, Guilin 541004, China. Electronic address:

Article Synopsis
View Article and Find Full Text PDF
Article Synopsis
  • * Despite earlier dentist visits for preterm children (average around 2.5-2.8 years), 63.87% of them still had no dental visits, with more complex treatments needed compared to full-term peers.
  • * Early dental visits before age 1 are linked to less severe dental issues, highlighting the importance of regular dental screenings for managing oral health in preterm infants.
View Article and Find Full Text PDF

Atypical femoral fracture (AFF) is generally a rare complication of long-term use of bisphosphonate (BP); glucocorticoid (GC) use and Asian race are also risk factors. Femoral localized periosteal thickening (LPT, also termed "beaking") of the lateral cortex often precedes AFF. This cohort study investigated the incidence of LPT and AFF and their clinical courses over 10 yr in patients with autoimmune inflammatory rheumatic diseases (AIRDs) treated with BP and GC.

View Article and Find Full Text PDF

Early blood glucose screening in asymptomatic high-risk neonates.

J Pediatr Endocrinol Metab

August 2024

Division of Neonatology, Department of Pediatrics, 24998 NYU Langone Hospital - Long Island, NYU Grossman Long Island School of Medicine, Mineola, NY, USA.

Objectives: Detecting and treating severe hypoglycemia promptly after birth is crucial due to its association with adverse long-term neurodevelopmental outcomes. However, limited data are available on the optimal timing of glucose screening in asymptomatic high-risk neonates prone to hypoglycemia. Risk factors associated with asymptomatic high-risk neonates include late prematurity ≥35 and <37 weeks gestation (LPT), small-for-gestational-age (SGA), large-for-gestational-age (LGA), and infant-of-a-diabetic mother (IDM).

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!