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Incidence, predictors of success and outcome of LISA in very preterm infants
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  • Gergely Balázs,
  • Andras Balajthy,
  • Magdolna Riszter,
  • Tamas Szabo,
  • Tamas Kovacs,
  • Gusztav Belteki,
  • Gyorgy Balla
Gergely Balázs
University of Debrecen Clinical Centre

Corresponding Author:[email protected]

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Andras Balajthy
University of Debrecen Clinical Centre
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Magdolna Riszter
University of Debrecen Clinical Centre
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Tamas Szabo
University of Debrecen Clinical Centre
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Tamas Kovacs
University of Debrecen Clinical Centre
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Gusztav Belteki
Cambridge University Hospitals NHS Foundation Trust
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Gyorgy Balla
University of Debrecen Clinical Centre
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Abstract

Objectives: To examine the success rate of less invasive surfactant administration (LISA), to identify early predictive factors for the outcome of LISA and to compare neonatal outcomes between the LISA failure group and the group of infants who were succesfully treated with LISA. Design: A retrospective cohort study. Patients: Infants born at less than 33 weeks of gestation (n=158) and treated with LISA for respiratory distress syndrome. Results: LISA was successful in 86 cases (54.4%), 72 preterm infants (45.6%) needed additional surfactant therapy and/or mechanical ventilation in the first 72 hours. In a multivariate logistic regression analysis, six independent predictors were identified: core temperature at the time of admission (adjusted OR 3.56), suboptimal dose of surfactant (adjusted OR 0.254), elevated CRP (>10 mg/L) at 24 hours of life (adjusted OR 0.28), highest respiratory severity score during the first hour of life or at the time of LISA (adjusted OR 0.463), maternal age (adjusted OR 0.923) and birth weight (adjusted OR 1.003). The ROC curve created by using the identified factors indicates good predictive power with an area under the curve of 0.85. LISA failure was associated with a substantially higher risk of pneumothorax, bronchopulmonary dysplasia, intraventricular hemorrhage, severe retinopathy of prematurity, longer duration of mechanical ventilation and prolonged length of hospital stay. Conclusion: Failure of LISA is relatively frequent event in very preterm infants and is associated with adverse outcomes. Prevention of hypothermia during early stabilization and appropriate dosing of surfactant increase may LISA success rates and improve patient outcome.
03 Sep 2021Submitted to Pediatric Pulmonology
11 Sep 2021Submission Checks Completed
11 Sep 2021Assigned to Editor
13 Sep 2021Reviewer(s) Assigned
11 Oct 2021Review(s) Completed, Editorial Evaluation Pending
20 Oct 2021Editorial Decision: Revise Major
07 Dec 20211st Revision Received
08 Dec 2021Submission Checks Completed
08 Dec 2021Assigned to Editor
08 Dec 2021Reviewer(s) Assigned
16 Dec 2021Review(s) Completed, Editorial Evaluation Pending
18 Dec 2021Editorial Decision: Accept
26 Apr 2022Published in Pediatric Pulmonology. 10.1002/ppul.25798