Comparison of Three Different Administration Positions for Intratracheal Beractant in Preterm Newborns with Respiratory Distress Syndrome

Abstract

In terms of efficacy and side effects, no important difference was observed between the recommended four position beractant application, the two position administration, and the neutral position.

Turkish Neonatal Society guideline on the management of respiratory distress syndrome and surfactant treatment

“…There is insufficient data on which position the surfactant application is most effective. In a study in which three different surfactant administration positions were compared, no difference was found between positions in terms of efficacy and adverse effects (18). The patient should be closely monitored during and after the procedure for endotracheal tube obstruction, apnea, desaturation, bradycardia, tachycardia, surfactant reflux, volutrauma, hyperventilation, pulmonary hemorrhage, unilateral surfactant application, and increased risk for hemodynamically significant patent ductus arteriosus (hsPDA).…”

The Efficacy of Neutral Position Beractant Administration in Neonates

“…In our control group 1,000 g or less showed an improved change in FiO 2 as compared with neonates weighing more than 1,000 g; however, this was similar in our study group (►Table 4). The increased efficacy in neonates of smaller weight contributed to the approval of beractant for prevention of RDS in neonates weighing < 1,250 g. 7 When comparing this retrospective study to the previous study published by Karadag et al, 13 there are a few differences between baseline characteristics. Our sample included patients of all ages and weights, had a higher percentage of antenatal steroid use, and beractant administration was over minutes and not seconds.…”

“…To provide 80% power to detect a 10% difference (standard deviation 16%) of the change in FiO 2, which was considered clinically significant based on results from a previous study, 13 and assuming a two-tailed α value of 0.05, it was determined that at least 40 patients per group would be needed. An independent Student's t-test for equality of means was used to compare the change in FiO 2 between the groups, as well as other continuous data.…”

“…A recently published study by Karadag et al 13 reviewed the safety and efficacy of beractant administration in neonates 26 to 32 weeks' gestational age weighing 600 to 1,500 g. The neutral position was compared with both four separate aliquots and positions and two separate aliquots and positions. No differences in terms of efficacy or adverse events were seen between giving beractant in four positions versus two positions versus the neutral position.…”