Early Surfactant Replacement Guided by Lung Ultrasound in Preterm Newborns with RDS: the ULTRASURF Randomised Controlled Trial

Overview

Journal Eur J Pediatr

Specialty Pediatrics

Date 2020 Jul 26

PMID 32710304

Citations 29

Authors

Javier Rodriguez-Fanjul

I Jordan

M Balaguer

A Batista-Munoz

M Ramon

S Bobillo-Perez

Affiliations

Soon will be listed here.

Abstract

This study aimed to investigate whether using lung ultrasound (LUS) scores in premature newborns with respiratory distress syndrome (RDS) allows for earlier surfactant therapy (within the first 3 h of life) than using FiO criteria. This was a randomised, non-blinded clinical trial conducted in a neonatal intensive care unit. The inclusion criteria were newborns with a gestational age of ≤ 32 weeks and RDS. Patients meeting the inclusion criteria were randomly assigned to two groups: the ultrasound group, administered surfactant based on LUS score and/or FiO threshold, and the control group, guided by FiO only. Fifty-six patients were included. The ultrasound group received surfactant earlier (1 h of life vs. 6 h, p < 0.001), with lower FiO (25% vs. 30%, p = 0.016) and lower CO (48 vs. 54, p = 0.011). After surfactant treatment, newborns in the ultrasound group presented a greater SpO (p = 0.001) and SpO/FiO ratio (p = 0.012).Conclusions: LUS score allowed an earlier surfactant therapy, reduced oxygen exposure early in life and a better oxygenation after the treatment. This early surfactant replacement may lead to reduced oxygen exposure. What is Known: • Lung ultrasound scores predict the need for surfactant therapy in premature newborns. What is New: • This study shows that using lung ultrasound scores improves the timeliness of surfactant replacement compared with using FiO alone.

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