Objective: To assess outcome of InSuRE (Intubation, Surfactant and Rapid Extubation) in managing preterm neonates with respiratory distress syndrome (RDS).
Methods: Preterm neonates fulfilling inclusion criteria were enrolled after obtaining informed parental consent. Criteria for success of InSuRE was predefined. Proportion of neonates with success or failure of InSuRE was the primary outcome.
Results: From August 2008 through July 2009, 28 babies underwent InSuRE. Sixteen babies (57 %) succeeded InSuRE. Median birth weight in successful group was 1362.5 (850-2,150) g and in failure group was 1,805 (990-2,560) g (p = 0.015). Nasal continuous positive airway pressure (nCPAP) was started at 0.5 (0-5.0) h of life in successful group and at 3.0 (0.5-6.0) h in failure group (p = 0.005). Babies in successful group received surfactant at median age of 2.0 (1.0-6.0) h, and in failure group at 4.0 (2.0-8.0) h (p = 0.002). Two patients in successful group died of neonatal sepsis, while none died in failure group (p = 0.492).
Conclusions: InSuRE is feasible in developing countries. However, we need large multicentric randomised controlled trials to prove the safety and efficacy in our settings.