Effectiveness of Less Invasive Surfactant Administration in Preterm with Respiratory Distress Syndrome

Abstract

Background: Neonatal respiratory distress syndrome due to surfactant deficiency is associated with high morbidity and mortality in preterm infants. While studies have should that early treatment with surfactant therapy has markedly reduced mortality. There are certain methods by which surfactant can be given, the most common initially used was intubation and mechanical ventilation which itself is also associated with many complications. LISA i.e. less invasive surfactant administration is an emerging technique in which surfactant is given via soft tube without intubation and oxygen support given with nasal CPAP, which has been internationally studied and preferred with significantly reduced need of mechanical ventilation. Objective: To determine the effectiveness of Less Invasive Surfactant Administration (LISA) in preterm neonates with respiratory distress syndrome. Study Design: Descriptive, case series. Settings: Department of neonatology of children hospital, PIMS Hospital, Islamabad Pakistan. Duration: Total 6 months duration from 31st August 2019 to 28th February 2020. Methods: A total of 85 preterm babies with respiratory distress 2 syndrome fulfilling the following criteria were selected. Extremely and very low birth weight i.e. <1.5kg and extremely sick were excluded. Patients were given surfactant through the soft nasotracheal tube and put on CPAP and the children's condition was assessed during 72 hours of procedure for improvement and related complications like pneumothorax, need of mechanical ventilation and mortality. Neonates having earlier clinical improvement with no prolonged need of mechanical ventilation and having fewer complications were considered effective. Results: Mean gestational age was 33.08 ± 1.35 weeks. Out of the 85 patients, 46 (54.12%) were male and 39 (45.88%) were females with male to female ratio of 1.2:1. Mean birth weight was 2.50 ± 0.73 kg. The effectiveness of LISA in preterm neonates with respiratory distress syndrome was found in 63 (74.12%) patients. Conclusion: This study concluded that the effectiveness of LISA in preterm neonates with respiratory distress syndrome is quite high.