dc.contributor.author | Reigstad, Hallvard | |
dc.contributor.author | Hufthammer, Karl Ove | |
dc.contributor.author | Rønnestad, Arild Erland | |
dc.contributor.author | Klingenberg, Claus Andreas | |
dc.contributor.author | Stensvold, Hans Jørgen | |
dc.contributor.author | Markestad, Trond Jacob | |
dc.date.accessioned | 2022-11-30T09:55:21Z | |
dc.date.available | 2022-11-30T09:55:21Z | |
dc.date.issued | 2022-07-27 | |
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.citation | Reigstad 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):1-10 | en_US |
dc.identifier.cristinID | FRIDAID 2054295 | |
dc.identifier.doi | 10.1136/bmjpo-2022-001527 | |
dc.identifier.issn | 2399-9772 | |
dc.identifier.uri | https://hdl.handle.net/10037/27614 | |
dc.language.iso | eng | en_US |
dc.publisher | BMJ Publishing Group | en_US |
dc.relation.journal | BMJ Paediatrics Open | |
dc.rights.accessRights | openAccess | en_US |
dc.rights.holder | Copyright 2022 The Author(s) | en_US |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0 | en_US |
dc.rights | Attribution 4.0 International (CC BY 4.0) | en_US |
dc.title | Early surfactant and non-invasive ventilation versus intubation and surfactant: a propensity score-matched national study | en_US |
dc.type.version | publishedVersion | en_US |
dc.type | Journal article | en_US |
dc.type | Tidsskriftartikkel | en_US |
dc.type | Peer reviewed | en_US |