Does timing of initial surfactant treatment make a difference in rates of chronic lung disease or mortality in premature infants? An observational regional study

AbstractObjective: To compare two treatment strategies in preterm infants with or at risk of respiratory distress syndrome: early surfactant administration (within one hour of birth) versus late surfactant administration, in a geographically defined population.Outcome: The primary outcome was chronic lung disease (CLD) and mortality before/at 36 weeks. Secondary outcomes included: duration of mechanical ventilation and continuous positive airway pressure (CPAP), post-natal steroids for CLD and major neonatal morbidities.Subjects: Premature infants born at 22–32 weeks’ gestation between January 2006 and December 2009.Setting: Ten neonatal intensive care units (NICUs) in New South Wales (NSW) and Australian Capital Territory (ACT), Australia.Design: Retrospective analysis of prospectively collected data from the regional NICU database in NSW and ACT.Results: Of the 2170 infants who received surfactant, 1182 (54.5%) and 988 (45.5%) received early and late surfactant, respectively. The early surfactant group ...