Pediatric pulmonology
Effectiveness of Surfactant Administration in Two Different Methods (MIST, INSURE) on the Short-Term Outcome of Preterm Infants With Respiratory Distress Syndrome: A Randomized Clinical Trial
By Heidarzadeh F, Pournajaf S, Akbarian-Rad Z and 3 others.
Abstract
Introduction
Preterm birth (< 37 weeks) causes high neonatal mortality, with respiratory distress syndrome (RDS) as a major complication due to surfactant deficiency. Surfactant administered via several methods. This study compares effectiveness and complications of two different methods of surfactant therapy.
Methods
This randomized clinical trial was conducted involving two groups of a total of 80 neonates aged 28-34 weeks who, based on clinical conditions, required surfactant administration. In the INSURE method, the infant is first intubated with an appropriate size endotracheal tube, subsequently, surfactant is administered in a controlled manner using a feeding catheter and 20 cmH2O positive pressure ventilation (PPV) and 5 cmH2O positive end expiratory pressure (PEEP) with a T-piece device, and in the MIST method, while the infant is on nasal CPAP with a PEEP of 5 cmH2O, a thin feeding catheter is inserted into the trachea and Surfactant is then slowly administered at the same dose, the catheter is immediately removed and nasal CPAP is continued. And the outcomes included the duration of respiratory support, need for surfactant re-administration, mechanical ventilation and complications such as pulmonary hemorrhage, pneumothorax evaluated.