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Surfactant use in late preterm infants: a survey among Belgian neonatologists.

Authors
  • Cornette, L1
  • Mulder, A2
  • Debeer, A3
  • Malfilâtre, G4
  • Rigo, V5
  • Cools, F6
  • Danhaive, O7, 8
  • 1 AZ St-Jan Brugge, Ruddershove 10, 8000, Bruges, Belgium. [email protected] , (Belgium)
  • 2 UZ Antwerpen, Wilrijkstraat 10, 2650, Edegem, Belgium. , (Belgium)
  • 3 UZ Leuven, Herestraat 49, 3000, Leuven, Belgium. , (Belgium)
  • 4 CHU Tivoli, Avenue Max Buset 34, 7100, La Louvière, Belgium. , (Belgium)
  • 5 CHU de Liège, Boulevard du Douzième de Ligne 1, 4000, Liège, Belgium. , (Belgium)
  • 6 UZ Brussel, Avenue du Laerbeek 101, 1090, Jette, Belgium. , (Belgium)
  • 7 UC Louvain, Place de l'Université 1, 1348, Ottignies-Louvain-la-Neuve, Belgium. , (Belgium)
  • 8 Department of Pediatrics, Benioff Children's Hospital, University of California San Francisco, San Francisco, CA, USA.
Type
Published Article
Journal
European Journal of Pediatrics
Publisher
Springer-Verlag
Publication Date
Mar 01, 2021
Volume
180
Issue
3
Pages
885–892
Identifiers
DOI: 10.1007/s00431-020-03806-1
PMID: 32970243
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Specific recommendations on surfactant administration in late preterm (LPT) infants with pulmonary disease are lacking. We performed an online-based, nationwide survey amongst all (n = 102) Belgian neonatologists to identify the use of surfactant in LPT infants suffering from several respiratory pathologies. The survey used clearly defined clinical cases and resulted in a 86% response rate. Neonatologists adhere to the 200 mg/kg initial surfactant dosing scheme. Surfactant is widely used in respiratory distress syndrome (70.1%), but there is less unanimity on its use in meconium aspiration syndrome (58.0%), transient tachypnoea of the newborn (30.6%), congenital pneumonia (27.2%) and congenital diaphragmatic hernia (8.6%). Respondents adhere to the European guideline of a timely referral to a newborn intensive care unit (non-invasive ventilation and FiO2 > 0.30 at 12 h of age), in order to minimise the risk of deterioration.Conclusion: We demonstrate a wide variety in the use of surfactant within LPT infants. The majority of Belgian neonatologists therefore urge for an investment in multi-centre trials on surfactant administration in LPT infants, in order to create an evidence-based practice as well as to reduce the strain on health care budgets.Trial registration: https://clinicaltrials.gov What is Known: • Any late preterm (LPT) infant with respiratory distress needs a timely referral to a neonatal intensive care unit in case of non-invasive ventilation and FiO2 > 0.30 at 12 h of life, in order to minimise the risk of acute deterioration as well as chronic lung disease. • Any modest increase in morbidity in the sizeable group of LPT infants exerts a significant strain on health care budgets. What is New: • We report the attitudes and opinions of Belgian neonatologists about the use of surfactant in LPT infants suffering from several respiratory diseases. • Our survey demonstrates a significant variability in practice between neonatologists during treatment of respiratory pathologies in LPT infants. This highlights an urgent need for univocal therapeutic lines.

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