A new method of surfactant administration in preterm infants.

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4 Citations (Scopus)


Surfactant treatment substantially improves outcomes for preterm infants with respiratory distress syndrome.1 However, the optimal timing and method of administration of this treatment are less clear.2, 3 and 4 In The Lancet, Wolfgang Göpel and colleagues, 5 on behalf of the German Neonatal Network, report the results of a multicentre randomised controlled trial investigating a new minimally invasive method of early surfactant administration in spontaneously breathing preterm infants who are supported with continuous positive airway pressure. Compared with the intubate, surfactant, and extubate technique, 6 in which surfactant is administered during a short period of positive pressure ventilation, this new intervention could offer an advantage because positive pressure ventilation can be avoided completely. In Göpel and colleagues' trial 220 preterm infants of a gestational age between 26 and 28 weeks and a birthweight less than 1500 g were randomly assigned to receive either early surfactant administration during spontaneous breathing or a standard approach of intubation when judged appropriate, then surfactant administration during mechanical ventilation. In the intervention group, the need for mechanical ventilation on day 2 or 3 after birth, or the risk of being not ventilated but having a partial pressure of carbon dioxide more than 65 mm Hg (8·6 kPa) or a fraction of inspired oxygen of more than 0·60, or both, for more than 2 h between 25 h and 72 h of age, was significantly lower than in the control group, with an absolute risk reduction of 0·18 (95% CI 0·30-0·05) and a number needed to treat of 6 (3-20).
Original languageEnglish
Title of host publicationLancet
Number of pages2
Publication statusPublished - 5 Nov 2011

Publication series



  • premature infants
  • exogenous surfactant


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