Universität zu Köln

Haertel, Christoph, Paul, Pia, Hanke, Kathrin, Humberg, Alexander, Kribs, Angela, Mehler, Katrin, Vochem, Matthias, Wieg, Christian, Roll, Claudia, Herting, Egbert and Goepel, Wolfgang (2018). Less invasive surfactant administration and complications of preterm birth. Sci Rep, 8. LONDON: NATURE PUBLISHING GROUP. ISSN 2045-2322

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Abstract

In a large cohort study of the German Neonatal Network (GNN) we aimed to evaluate whether less invasive surfactant administration (LISA) strategy is associated with complications of preterm birth. Within the observational period n = 7533 very-low-birth-weight infants (VLBWI) with gestational age 22 0/7 to 28 6/7 weeks were enrolled in GNN; n = 1214 VLBWI never received surfactant, n = 2624 VLBWI were treated according to LISA procedure, n = 3695 VLBWI had surfactant via endotracheal tube (ETT). LISA was associated with a reduced risk for adverse outcome measures including mortality [odds ratio (OR) 0.66 (95% CI: 0.51-0.84), p < 0.001] bronchopulmonary dysplasia [BPD; OR 0.55 (95% CI: 0.49-0.62), p < 0.001], intracerebral hemorrhage (ICH) grade II-IV [OR 0.55 (95% CI: 0.48-0.64), p < 0.001] and retinopathy of prematurity [ROP; OR 0.62 (95% CI: 0.45-0.85), p < 0.001]. Notably, LISA was associated with an increased risk for focal intestinal perforation [FIP; OR 1.49 (95% CI: 1.14-1.95), p = 0.002]. The differences in FIP rates were primarily observed in VLBWI born < 26 weeks (LISA: 10.0 vs. ETT: 7.4%, p = 0.029). Our observational data confirm that LISA is associated with improved outcome. In infants < 26 weeks we noted an increased risk for FIP. Future randomized controlled trials including LISA need to integrate safety analyses for this particular subgroup.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Haertel, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Paul, Pia UNSPECIFIED UNSPECIFIED UNSPECIFIED Hanke, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Humberg, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Kribs, Angela UNSPECIFIED UNSPECIFIED UNSPECIFIED Mehler, Katrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Vochem, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Wieg, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Roll, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED Herting, Egbert UNSPECIFIED UNSPECIFIED UNSPECIFIED Goepel, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-185934
DOI:	10.1038/s41598-018-26437-x
Journal or Publication Title:	Sci Rep
Volume:	8
Date:	2018
Publisher:	NATURE PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	2045-2322
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SPONTANEOUS INTESTINAL PERFORATION; WEIGHT INFANTS; NEURODEVELOPMENTAL OUTCOMES; NECROTIZING ENTEROCOLITIS; THERAPY; ASSOCIATION; VENTILATION; MORTALITY; GERMANY Multiple languages Multidisciplinary Sciences Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18593