An Evaluation of Two Different Surfactant Application Methods in Preterm Infants

Introduction: Less invasive surfactant application (LISA) techniques are being investigated in order to reduce alveolar damage during exogenous surfactant application. This study analyses the therapeutic outcomes of the LISA and INSURE (INtubation SURfactant and Extubation) exogenous surfactant application techniques in premature babies. Materials and Methods: Ninety-three premature babies born at the 36th week of pregnancy or earlier in the neonatal intensive care unit and administered surfactant using the INSURE (n=44) and LISA (n=49) methods were included in this prospective study. The two groups were evaluated in terms of treatment outcomes and the presence of complications of prematurity. Results: The study population consisted of 37 (39.8%) girls and 56 (60.2%) boys. Twelve (27.3%) of the babies in Group 1 (the INSURE group) received Poractant, 24 (54.5%) Beractant, and eight (18.2%) Calfactant surfactant preparation. Poractant surfactant preparation was administered to all the babies in Group II (the LISA group). No significant differences were detected when the patients in groups I and II were compared in terms of repeat surfactant requirements, Clinical Risk of Babies (CRIB) scores, PaCO2, body temperature, days of mechanical ventilation, days of nasal continuous positive airway pressure, duration of use of oxygen hoods, and length of stay (p>0.05). No significant differences were also observed between the two groups in terms of complications developing during follow-up (pneumothorax, pulmonary hemorrhage, bronchopulmonary dysplasia [BDP], intraventricular bleeding, and retinopathy of prematurity [ROP]) (p>0.05). However, the risk of BPD and ROP development was significantly greater in babies with high CRIB scores p=0,0003 and p=0,03). Conclusion: Our comparison of the less invasive LISA and INSURE methods revealed no statistically significant difference in terms of treatment outcomes or complications. Further prospective studies involving new approaches and forms of treatment, their applicability, and larger numbers of cases are now needed.

Journal

GUNCEL PEDIATRI-JOURNAL OF CURRENT PEDIATRICS

Year

2025

Volume

23

Issue

3

Pages

213-220

ISSN

1304-9054

eISSN

1308-6308

DOI

10.4274/jcp.2025.22438

WoS UID

WOS:001653450900001