Respiratory Severity Score during the First 3 Hours of Life as a Predictor for Failure of Noninvasive Respiratory Support and Need for Late Rescue Surfactant Administration

Abstract

Objective Preterm infants often develop failure of noninvasive respiratory support. These infants miss the advantages of early rescue surfactant therapy. In this study, we evaluate the utility of respiratory severity score (RSS) during the first 3 hours of life (HOL) as a predictor for failure of noninvasive respiratory support. Study Design We conducted a post hoc analysis of infants between 23 and 40 weeks' gestational age who received usual care in the AERO-02 clinical trial. Univariate and multivariable logistic regression analysis were used to assess whether the RSS summary measures were associated with the odds of surfactant administration. Results Study involved 146 infants. Sixty-four infants (45%) received surfactant within the first 72 hours. Administration of surfactant was associated with the mean RSS (p < 0.01) and the linear trend (p < 0.01). Conclusion We demonstrated that RSS during the first 3 HOL can predict failure of noninvasive respiratory support and need for late rescue surfactant administration. Optimal RSS cutoffs for early rescue surfactant therapy need to be determined in large cohort studies. Key Points

Respiratory Severity Score and Oxygen Saturation Index during the first two hours of life as predictors for non-invasive respiratory support failure in moderate preterm infants with respiratory distress syndrome

“…Early identi cation allows implementation of targeted interventions aimed at prevention of NRS failure. (10) Respiratory Severity Score (RSS) and Oxygen Saturation Index (OSI) are continuous non-invasive markers to assess pulmonary status (11)(12)(13)(14)(15). In this study, we evaluate the utility of RSS and OSI during the rst 2 HOL as a predictor for NRS failure in preterm infants during the rst 72 HOL.…”