Clinical predictors for surfactant retreatment in preterm infants with respiratory distress syndrome: the results of a pooled analysis
Abstract Background The issue of retreatment with surfactant of infants with respiratory distress syndrome (RDS) has been poorly investigated. Our aim was to identify possible clinical predictors of the need for multiple doses of surfactant in a large cohort of very preterm infants. Methods Data wer...
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2025-01-01
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| Series: | Italian Journal of Pediatrics |
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| Online Access: | https://doi.org/10.1186/s13052-024-01828-1 |
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| author | Carlo Dani Chiara Poggi Massimo Agosti Massimo Bellettato Pasqua Betta Paolo Biban Luigi Corvaglia Raffaele Falsaperla Carlo Forcellini Diego Gazzolo Eloisa Gitto Camilla Gizzi Paola Lago Gianluca Lista Gianfranco Maffei Fabio Mosca Marcello Napolitano Gianfranco Scarpelli Fabrizio Sandri Daniele Trevisanuto Giovanni Vento Iuri Corsini Simone Pratesi Luca Boni |
| author_facet | Carlo Dani Chiara Poggi Massimo Agosti Massimo Bellettato Pasqua Betta Paolo Biban Luigi Corvaglia Raffaele Falsaperla Carlo Forcellini Diego Gazzolo Eloisa Gitto Camilla Gizzi Paola Lago Gianluca Lista Gianfranco Maffei Fabio Mosca Marcello Napolitano Gianfranco Scarpelli Fabrizio Sandri Daniele Trevisanuto Giovanni Vento Iuri Corsini Simone Pratesi Luca Boni |
| author_sort | Carlo Dani |
| collection | DOAJ |
| description | Abstract Background The issue of retreatment with surfactant of infants with respiratory distress syndrome (RDS) has been poorly investigated. Our aim was to identify possible clinical predictors of the need for multiple doses of surfactant in a large cohort of very preterm infants. Methods Data were analyzed from three previous studies on infants born between 25+ 0 and 31+ 6 weeks of gestation with RDS who were treated with surfactant. Results We studied 448 infants. Among them 306 (68%) were treated with a single dose of surfactant and 142 (32%) were treated with multiple doses. Multivariable mixed effects logistic regression analysis showed that the odd of requiring multiple doses of surfactant was significantly lower in patients with higher gestational age (27–28 vs. 25–26 wks: OR 0.46, 95% C.l. 0.26–0.79; ≥29 vs. 25–26 wks: OR 0.34, 95% C.l. 0.13–0.85; overall P = 0.013), while it increased in infants born to mothers with hypertensive disorders of pregnancy (OR 2.53, 95% C.l. 1.49–4.31; P < 0.001) and with hemodynamically significant PDA (OR 2.74, 95% C.l. 1.66–4.53, P < 0.001). Conclusions Gestational age, hypertension in pregnancy, and hemodynamically significant PDA can predict the need for multiple doses of surfactant. Further investigation is needed to evaluate if these sub-groups of preterm infants represent specific phenotypes of RDS who deserve a peculiar surfactant treatment. |
| format | Article |
| id | doaj-art-4eea05822f064043aab807bed27e8053 |
| institution | Kabale University |
| issn | 1824-7288 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Italian Journal of Pediatrics |
| spelling | doaj-art-4eea05822f064043aab807bed27e80532025-01-12T12:33:26ZengBMCItalian Journal of Pediatrics1824-72882025-01-015111810.1186/s13052-024-01828-1Clinical predictors for surfactant retreatment in preterm infants with respiratory distress syndrome: the results of a pooled analysisCarlo Dani0Chiara Poggi1Massimo Agosti2Massimo Bellettato3Pasqua Betta4Paolo Biban5Luigi Corvaglia6Raffaele Falsaperla7Carlo Forcellini8Diego Gazzolo9Eloisa Gitto10Camilla Gizzi11Paola Lago12Gianluca Lista13Gianfranco Maffei14Fabio Mosca15Marcello Napolitano16Gianfranco Scarpelli17Fabrizio Sandri18Daniele Trevisanuto19Giovanni Vento20Iuri Corsini21Simone Pratesi22Luca Boni23Department of Neurosciences, Psychology, Drug Research and Child Health, University of FlorenceDepartment of Neurosciences, Psychology, Drug Research and Child Health, University of FlorenceMaternal and Child Health Department, Del Ponte HospitalDivision of Neonatology, Ospedale San BortoloNeonatal Intensive Care Unit, Azienda Ospedaliero-Universitaria Policlinico - Vittorio Emanuele of CataniaDepartment of Pediatrics, Pediatric and Neonatal intensive Care Unit, Azienda Ospedaliera Universitaria IntegrataNeonatal Intensive Care Unit, Department of Medical and Surgical Sciences, IRCCS AOUBO, University of BolognaNeonatal Intensive Care Unit and Neonatal Accompaniment Unit, San Marco Hospital, Azienda Ospedaliero-Universitaria Policlinico “Rodolico-San Marco”, University of CataniaDepartment of Pediatrics, Pediatric and Neonatal intensive Care Unit, Azienda Ospedaliera Universitaria IntegrataDepartment of Maternal Fetal and Neonatal Medicine, C. Arrigo Children’s HospitalDepartment of Human Pathology in Adult and Developmental Age “Gaetano Barresi”, Neonatal and Paediatric Intensive Care Unit, University of MessinaDivision of Neonatology, S. Giovanni Calibita Hospital Fatebenefratelli, Isola TiberinaNeonatal Intensive Care Unit and High-Risk Follow up program, Cà Foncello Regional Hospital, Azienda ULSS 2 Marca Trevigiana of TrevisoDivision of Neonatology, “V. Buzzi” Children’s Hospital – ASST-FBF-SaccoDivision of Neonatology, Neonatal Intensive Care Unit, Azienda Ospedaliero-UniversitariaNeonatal Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico of MilanDivision of Neonatology and Neonatal Intensive Care Unit, Ospedale Evangelico Betania of NaplesDivision of Neonatology and Neonatal Intensive Care Unit, Azienda Ospedaliero Universitaria of CosenzaMaternal and Pediatrics Department, Maggiore HospitalDepartment of PediatricsDivision of Neonatology, Catholic University of RomeDepartment of Neurosciences, Psychology, Drug Research and Child Health, University of FlorenceDepartment of Neurosciences, Psychology, Drug Research and Child Health, University of FlorenceSC Epidemiologia Clinica, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino of GenovaAbstract Background The issue of retreatment with surfactant of infants with respiratory distress syndrome (RDS) has been poorly investigated. Our aim was to identify possible clinical predictors of the need for multiple doses of surfactant in a large cohort of very preterm infants. Methods Data were analyzed from three previous studies on infants born between 25+ 0 and 31+ 6 weeks of gestation with RDS who were treated with surfactant. Results We studied 448 infants. Among them 306 (68%) were treated with a single dose of surfactant and 142 (32%) were treated with multiple doses. Multivariable mixed effects logistic regression analysis showed that the odd of requiring multiple doses of surfactant was significantly lower in patients with higher gestational age (27–28 vs. 25–26 wks: OR 0.46, 95% C.l. 0.26–0.79; ≥29 vs. 25–26 wks: OR 0.34, 95% C.l. 0.13–0.85; overall P = 0.013), while it increased in infants born to mothers with hypertensive disorders of pregnancy (OR 2.53, 95% C.l. 1.49–4.31; P < 0.001) and with hemodynamically significant PDA (OR 2.74, 95% C.l. 1.66–4.53, P < 0.001). Conclusions Gestational age, hypertension in pregnancy, and hemodynamically significant PDA can predict the need for multiple doses of surfactant. Further investigation is needed to evaluate if these sub-groups of preterm infants represent specific phenotypes of RDS who deserve a peculiar surfactant treatment.https://doi.org/10.1186/s13052-024-01828-1SurfactantMultiple doseRespiratory distress syndromePreterm infants |
| spellingShingle | Carlo Dani Chiara Poggi Massimo Agosti Massimo Bellettato Pasqua Betta Paolo Biban Luigi Corvaglia Raffaele Falsaperla Carlo Forcellini Diego Gazzolo Eloisa Gitto Camilla Gizzi Paola Lago Gianluca Lista Gianfranco Maffei Fabio Mosca Marcello Napolitano Gianfranco Scarpelli Fabrizio Sandri Daniele Trevisanuto Giovanni Vento Iuri Corsini Simone Pratesi Luca Boni Clinical predictors for surfactant retreatment in preterm infants with respiratory distress syndrome: the results of a pooled analysis Italian Journal of Pediatrics Surfactant Multiple dose Respiratory distress syndrome Preterm infants |
| title | Clinical predictors for surfactant retreatment in preterm infants with respiratory distress syndrome: the results of a pooled analysis |
| title_full | Clinical predictors for surfactant retreatment in preterm infants with respiratory distress syndrome: the results of a pooled analysis |
| title_fullStr | Clinical predictors for surfactant retreatment in preterm infants with respiratory distress syndrome: the results of a pooled analysis |
| title_full_unstemmed | Clinical predictors for surfactant retreatment in preterm infants with respiratory distress syndrome: the results of a pooled analysis |
| title_short | Clinical predictors for surfactant retreatment in preterm infants with respiratory distress syndrome: the results of a pooled analysis |
| title_sort | clinical predictors for surfactant retreatment in preterm infants with respiratory distress syndrome the results of a pooled analysis |
| topic | Surfactant Multiple dose Respiratory distress syndrome Preterm infants |
| url | https://doi.org/10.1186/s13052-024-01828-1 |
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