Minimally invasive surfactant administration in extremely preterm infants <28 weeks gestation with spontaneous breathing: a retrospective quality improvement study on reducing invasive ventilation burden
Year: 2026
Type: article
Abstract: Background: Invasive surfactant delivery via endotracheal intubation increases exposure to invasive mechanical ventilation (IMV) in extremely preterm infants (EPIs, <28 weeks). This quality improvement (QI) initiative aimed to evaluate whether minimally invasive surfactant administration (MISA) was associated with a reduced IMV burden in EPIs. Methods: = 60) received surfactant via thin catheter during nasal continuous positive airway pressure/nasal intermittent positive pressure ventilation (NCPAP/NIPPV). Apart from the structured implementation of MISA, background respiratory and supportive care practices evolved gradually over time without other major structural changes. Multivariable regression and interrupted time-series analyses were performed to account for potential confounding and secular trends. Results: > 0.05). Interrupted time-series analysis demonstrated an immediate reduction in early IMV duration following MISA implementation, whereas changes in secondary outcomes did not reach statistical significance. Conclusion: MISA was associated with reduced early and overall IMV exposure in EPIs <28 weeks, and with lower observed incidences of hsPDA and nosocomial pneumonia. These associations warrant confirmation in prospective multicenter studies.
Source: Frontiers in Pediatrics
Institution: Peking University Third Hospital
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7137122180