Incidence, predictors of success and outcome of LISA in very preterm infants.
Authors
Balajthy, Andras
Riszter, Magdolna
Kovacs, Tamas
Szabo, Tamas
Balla, Gyorgy
Publication Date
2021-12-20Journal Title
Pediatr Pulmonol
ISSN
8755-6863
Publisher
Wiley
Language
en
Type
Article
This Version
AO
VoR
Metadata
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Balazs, G., Balajthy, A., Riszter, M., Kovacs, T., Szabo, T., Belteki, G., & Balla, G. (2021). Incidence, predictors of success and outcome of LISA in very preterm infants.. Pediatr Pulmonol https://doi.org/10.1002/ppul.25798
Abstract
OBJECTIVES: The aim of this study was to examine the success rate of less invasive surfactant administration (LISA), to identify early predictive factors for the outcome of LISA, and to compare neonatal outcomes between the LISA failure group and the group of infants who were successfully treated with LISA. DESIGN: A retrospective cohort study. PATIENTS: Infants born at less than 33 weeks of gestation (n = 158) and treated with LISA for respiratory distress syndrome. RESULTS: LISA was successful in 86 cases (54.4%); 72 preterm infants (45.6%) needed additional surfactant therapy and/or mechanical ventilation in the first 72 h (LISA failure). In a multivariate logistic regression analysis, six independent predictors of LISA success were identified: core temperature at the time of admission (adjusted odds ratio (OR): 3.56), dose of poractant alfa (<200 mg/kg; adjusted OR: 0.254), elevated C-reactive protein (>10 mg/L) at 24 h of life (adjusted OR: 0.28), highest respiratory severity score (RSS) during the first hour of life or at the time of LISA (adjusted OR: 0.463), maternal age (adjusted OR: 0.923), and birth weight (adjusted OR: 1.003). The receiver operating curve created by using the identified factors indicates good predictive power with an area under the curve of 0.85. LISA failure was associated with a substantially higher risk of complications. CONCLUSION: LISA success can be predicted by variables available before the intervention. Failure of LISA is relatively frequent event in very preterm infants and is associated with adverse outcomes. Prevention of hypothermia during early stabilization and appropriate dosing of surfactant may increase LISA success rates and improve patient outcome.
Keywords
ORIGINAL ARTICLE: NEONATAL LUNG DISEASE, continuous positive airway pressure, respiratory distress syndrome in premature infants, surfactant
Identifiers
ppul25798
External DOI: https://doi.org/10.1002/ppul.25798
This record's URL: https://www.repository.cam.ac.uk/handle/1810/336456
Rights
Licence:
http://creativecommons.org/licenses/by-nc/4.0/
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