Outcomes at 7 Years of Age of Former Very Preterm Neonates with Repeated Surfactant Treatment for Prolonged Respiratory Distress in the Neonatal Period - Université de Picardie Jules Verne Accéder directement au contenu
Article Dans Une Revue Journal of Clinical Medicine Année : 2023

Outcomes at 7 Years of Age of Former Very Preterm Neonates with Repeated Surfactant Treatment for Prolonged Respiratory Distress in the Neonatal Period

Outcomes at 7 Years of Age of Former Very Preterm Neonates with Repeated Surfactant Treatment for Prolonged Respiratory Distress in the Neonatal Period.

Résumé

This study aimed at evaluating the 7-year outcomes of 118 very preterm newborns (VPNs, gestational age = 26 ± 1.4 w) involved in a randomized controlled trial. They presented neonatal respiratory distress (RDS), requiring ventilation for 14 ± 2 days post-natal age (PNA). A repeated instillation of 200 mg/kg poractant alfa (SURF) did not improve early bronchopulmonary dysplasia, but the SURF infants needed less re-hospitalization than the controls for respiratory problems at 1- and 2-year PNA. There was no growth difference at 7.1 ± 0.3 years between 41 SURF infants and 36 controls (80% of the eligible children), and 7.9% SURF infants vs. 28.6% controls presented asthma (p = 0.021). The children underwent cognitive assessment (WISC IV) and pulmonary function testing (PFT), measuring their spirometry, lung volume, and airway resistance. The spirometry measures showed differences (p < 0.05) between the SURF infants and the controls (mean ± standard deviation (median z-score)) for FEV1 (L/s) (1.188 ± 0.690(−0.803) vs. 1.080 ± 0.243 (−1.446)); FEV1 after betamimetics (1.244 ± 0.183(−0.525) vs. 1.091 ± 0.20(−1.342)); FVC (L) (1.402 ± 0.217 (−0.406) vs. 1.265 ± 0.267 (−1.141)), and FVC after betamimetics (1.452 ± 0.237 (−0.241) vs. 1.279 ± 0.264 (−1.020)). PFT showed no differences in the volumes or airway resistance. The global IQ median (interquartile range) was 89 (82:99) vs. 89 (76:98), with 61% of the children >85 in both groups. Repeated surfactant treatment in VPNs presenting severe RDS led to the attenuation of early lung injuries, with an impact on long-term pulmonary sequelae, without differences in neurodevelopmental outcomes.
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hal-04250440 , version 1 (29-05-2024)

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Jean-Michel Hascoet, Hélène Deforge, Silvia Demoulin, Jean-Charles Picaud, Veronique Zupan, et al.. Outcomes at 7 Years of Age of Former Very Preterm Neonates with Repeated Surfactant Treatment for Prolonged Respiratory Distress in the Neonatal Period. Journal of Clinical Medicine, 2023, Journal of Clinical Medicine, 12 (19), pp.6220. ⟨10.3390/jcm12196220⟩. ⟨hal-04250440⟩
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