Less Invasive Surfactant Administration Reduces the Need for Mechanical Ventilation in Preterm Infants: A Meta-Analysis

Christine S M Lau; Ronald S Chamberlain; Shyan Sun

doi:10.1177/2333794X17696683

Less Invasive Surfactant Administration Reduces the Need for Mechanical Ventilation in Preterm Infants: A Meta-Analysis

Glob Pediatr Health. 2017 Mar 24:4:2333794X17696683. doi: 10.1177/2333794X17696683. eCollection 2017.

Authors

Christine S M Lau^{1

2}, Ronald S Chamberlain^{1

2

3

4}, Shyan Sun^{1

3}

Affiliations

¹ Saint Barnabas Medical Center, Livingston, NJ, USA.
² Saint George's University, Grenada, West Indies.
³ New Jersey Medical School, Rutgers University, Newark, NJ, USA.
⁴ Banner MD Anderson Cancer Center, Gilbert, AZ, USA.

Abstract

Neonatal respiratory distress syndrome due to surfactant deficiency is associated with high morbidity and mortality in preterm infants, and the use of less invasive surfactant administration (LISA) has been increasingly studied. This meta-analysis found that LISA via thin catheter significantly reduced the need for mechanical ventilation within the first 72 hours (relative risk [RR] = 0.677; P = .021), duration of mechanical ventilation (difference in means [MD] = -39.302 hours; P < .001), duration of supplemental oxygen (MD = -68.874 hours; P < .001), and duration of nasal continuous positive airway pressure (nCPAP; MD = -28.423 hours; P = .010). A trend toward a reduction in the incidence of bronchopulmonary dysplasia was observed (RR = 0.656; P = .141). No significant difference in overall mortality, incidence of pneumothorax, or successful first attempts was observed. LISA via thin catheter significantly reduces the need for mechanical ventilation within the first 72 hours as well as the duration of mechanical ventilation, supplemental oxygen, and nCPAP. LISA via thin catheter appears promising in improving preterm infant outcomes.

Keywords: bronchopulmonary dysplasia; less invasive surfactant administration; meta-analysis; minimally invasive; neonatal respiratory distress syndrome; preterm; surfactant; thin catheter.