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dc.contributor.authorReigstad, Hallvard
dc.contributor.authorHufthammer, Karl Ove
dc.contributor.authorRønnestad, Arild Erland
dc.contributor.authorKlingenberg, Claus Andreas
dc.contributor.authorStensvold, Hans Jørgen
dc.contributor.authorMarkestad, Trond Jacob
dc.description.abstract<p><b> Objective</b> To compare outcome after less invasive surfactant administration (LISA) and primary endotracheal intubation (non-LISA) in infants born before gestational age (GA) 28 weeks. <p><b> Setting</b> All neonatal intensive care units (NICUs) in Norway during 2012–2018. <p><b> Methods</b> Defined population-based data were prospectively entered into a national registry. We compared LISA infants with all non-LISA infants and with non-LISA infants who received surfactant following intubation. We used propensity score (PS) matching to identify non-LISA infants who were similar regarding potential confounders. <p><b> Main outcome variables</b> Rate and duration of mechanical ventilation (MV), survival, neurological and gastrointestinal morbidity, and need of supplemental oxygen or positive pressure respiratory support at postmenstrual age (PMA) 36 and 40 weeks. <p><b> Results</b> We restricted analyses to GA 25–27 weeks (n=843, 26% LISA) because LISA was rarely used at lower GAs. There was no significant association between NICUs regarding proportions treated with LISA and proportions receiving MV. In the PS-matched datasets, fewer LISA infants received MV (61% vs 78%, p<0.001), and they had fewer days on MV (mean difference 4.1, 95% CI 0.0 to 8.2 days) and lower mortality at PMA 40 weeks (absolute difference 6%, p=0.06) compared with all the non-LISA infants, but only a lower rate of MV (64% vs 97%, p<0.001) and fewer days on MV (mean difference 5.8, 95% CI 0.6 to 10.9 days) compared with non-LISA infants who received surfactant after intubation. <p><b> Conclusion</b> LISA reduced the rate and duration of MV but had no other clear benefits.en_US
dc.identifier.citationReigstad H, Hufthammer KO, Rønnestad AE, Klingenberg C, Stensvold HJ, Markestad T. Early surfactant and non-invasive ventilation versus intubation and surfactant: a propensity score-matched national study. BMJ Paediatrics Open. 2022;6(1):1-10en_US
dc.identifier.cristinIDFRIDAID 2054295
dc.publisherBMJ Publishing Groupen_US
dc.relation.journalBMJ Paediatrics Open
dc.rights.holderCopyright 2022 The Author(s)en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleEarly surfactant and non-invasive ventilation versus intubation and surfactant: a propensity score-matched national studyen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US

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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's license is described as Attribution 4.0 International (CC BY 4.0)