Article ; Online: Impact of surfactant administration through a thin catheter in the delivery room: A quality control chart analysis coupled with a propensity score matched cohort study in preterm infants.
PloS one
2018 Volume 13, Issue 12, Page(s) e0208252
Abstract: Introduction: Most infants born before 30 weeks gestational age (GA) develop respiratory distress syndrome soon after birth. Methods of surfactant administration that avoid ventilation have been recently introduced. The aim of this study was to evaluate ...
| Abstract | Introduction: Most infants born before 30 weeks gestational age (GA) develop respiratory distress syndrome soon after birth. Methods of surfactant administration that avoid ventilation have been recently introduced. The aim of this study was to evaluate the impact of implementing a new procedure of less invasive surfactant administration (LISA) and determine whether it is associated with an improvement in respiratory outcome. Methods: This single center cohort quality improvement study analyzed preterm infants born before 30 weeks GA between May 2010 and April 2016. Changes in health care practices and respiratory outcomes following the implementation of a LISA, i.e. the administration of surfactant through a thin catheter, were analyzed using quality control charts. Then, the effect of LISA on respiratory outcome was assessed by propensity score matching and logistic regression weighted by the inverse of the propensity score. Results: During the study period, 379 infants were included. Of those that were not intubated at ten minutes of life, 129 received surfactant and were ventilated for one hour or more (InVent), 127 received LISA, five received surfactant with tracheal mechanical ventilation for less than one hour (InSurE), and 55 were only treated with nasal continuous positive pressure during the first hour of neonatal care (nCPAP). Quality-chart analysis revealed rapid implementation of the method with a concomitant decrease in required ventilation. LISA was associated with fewer tracheal ventilation days and a lower incidence of supplemental oxygen on day 28. When controlling for the propensity to be exposed or not to LISA, this procedure was not associated with a lower risk of death or bronchopulmonary dysplasia (BPD) at 36 weeks postmenstrual age. Conclusion: In this study, the successful implementation of the new method was associated with lower rates of mechanical ventilation, but without a significant reduction of grade I/II/III BPD or death. |
|---|---|
| MeSH term(s) | Bronchopulmonary Dysplasia/therapy ; Cohort Studies ; Delivery Rooms/statistics & numerical data ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Pregnancy ; Pulmonary Surfactants/administration & dosage ; Respiration, Artificial/methods |
| Chemical Substances | Pulmonary Surfactants |
| Language | English |
| Publishing date | 2018-12-12 |
| Publishing country | United States |
| Document type | Journal Article |
| ISSN | 1932-6203 |
| ISSN (online) | 1932-6203 |
| DOI | 10.1371/journal.pone.0208252 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.
Inter-library loan at ZB MED
Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.