The goal of this observational study is to evaluate different methods of surfactant administration in preterm infants with respiratory distress syndrome (RDS). Preterm infants often have immature lungs and a deficiency of surfactant, a substance that helps keep the lungs open and supports oxygen exchange.Surfactant can be delivered to the lungs using different techniques, including INSURE (brief intubation), LISA (via a thin catheter), SALSA (via a laryngeal mask airway), and traditional administration via endotracheal intubation followed by mechanical ventilation. The main question this study aims to answer is:Which method of surfactant administration is associated with better clinical outcomes in preterm infants with RDS?The study will prospectively collect clinical data on infants receiving surfactant as part of standard care, with long-term follow-up using data from the Swedish Neonatal Quality Register. The results are intended to be used to inform the design of a future randomized multicenter study.
Patient has received surfactant by any administration method
Gestational age below 37 weeks'
First surfactant treatment given before 48 hours of age
Confirmed or suspected diagnosis of respiratory distress syndrome (RDS)
None
Newborn infants admitted to neonatal units in Västra Götaland Region, Sweden.
Cohort
Prospective
Not listed
Mechanical ventilation or repeat surfactant within 72 hours after first surfactant treatment delivered by LISA, SALSA or INSURE method
Categorical variable (Yes/No). Decision to initiate mechanical ventilation via intubation will be made at the discretion of the treating physician, guided by the local NICU criteria for mechanical ventilation. Data is extracted from medical records.
Bradycardia <100 bpm (any duration)
Categorical variable (Yes/No). Measured by pulse oximetry and noted by team performing procedure.
Oesophageal/upper airway injury
Categorical (Yes/No). Observations of infant during and post-procedure. Details provided if present.
Bradycardia <60 bpm (any duration)
Categorical variable (Yes/No). Measured by pulse oximetry and noted by team performing procedure.
Desaturation to SpO₂ <80% lasting ≥30 seconds (single episode)
Categorical variable (Yes/No). Measured by pulse oximetry and noted by team performing procedure.
Pain score
Continous variable. Using neonatal pain scale. Centre specific and scale may vary.
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Vastra Gotaland Region
Lead sponsor
Göteborg University
Collaborator
