RETREATMENT WITH SURFACTANT IN VERY LOW BIRTH WEIGHT PRETERM INFANTS: RISK PREDICTORS AND THEIR INFLUENCE ON NEONATAL OUTCOMES.

Autor: Ferri WAG; Universidade de São Paulo, Ribeirão Preto, SP, Brazil., Silva ACD; Universidade de São Paulo, Ribeirão Preto, SP, Brazil., Sacramento EMF; Universidade de São Paulo, Ribeirão Preto, SP, Brazil., Calixto C; Universidade de São Paulo, Ribeirão Preto, SP, Brazil., Aragon DC; Universidade de São Paulo, Ribeirão Preto, SP, Brazil., Caldas JPS; Universidade Estadual de Campinas, Campinas, SP, Brazil.
Jazyk: English; Portuguese
Zdroj: Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo [Rev Paul Pediatr] 2020 Nov 16; Vol. 39, pp. e2019360. Date of Electronic Publication: 2020 Nov 16 (Print Publication: 2020).
DOI: 10.1590/1984-0462/2021/39/2019360
Abstrakt: Objective: To assess clinical predictors and outcomes associated to the need for surfactant retreatment in preterm infants.
Methods: Retrospective cohort study, including very low birth weight preterm infants from January 2006 to December 2015 who underwent surfactant replacement therapy. Beractant was used (100 mg/kg), repeated every six hours if FiO2 ≥0.40. The subjects were classified into two groups: single surfactant dose; and more than one dose (retreatment). We evaluated maternal and neonatal predictors for the need of retreatment and neonatal outcomes associated to retreatment.
Results: A total of 605 patients (44.5%) received surfactant; 410 (67.8%) one dose, and 195 (32.2%) more than one dose: 163 (83.5%) two doses and 32 (16.4%) three doses. We could not find clinical predictors for surfactant retreatment. Retreatment was associated to a greater chance of BPD in infants >1000 g (RR 1.78; 95%CI 1.30‒2.45) and ≤1000 g (RR 1.33; 95%CI 1.04‒1.70), in infants with gestational age<28 weeks (RR 1.56; 95%CI 1.12‒2.18) and ≥28 weeks (RR 1.50; 95%CI 1.17‒1.92), in neonates with early sepsis (RR 1.48; 95%CI 1.20‒1.81), and in infants not exposed to antenatal corticosteroids (RR 1.62; 95%CI 1.20‒2.17).
Conclusions: We could not find predictor factors associated to surfactant retreatment. The need for two or more doses of surfactant was significantly related to bronchopulmonary dysplasia.
Databáze: MEDLINE
Externí odkaz: