Comparison of mortality and short-term outcomes between classic, intubation-surfactant-extubation, and less invasive surfactant administration methods of surfactant replacement therapy

Background Intubation-Surfactant-Extubation (InSurE) and less invasive surfactant administration (LISA) are alternative replacement therapy methods for reducing the complications associated with mechanical ventilation. This study aimed to compare Classic, InSurE, LISA in Very-Low-Birth-Weight infants (VLBWIs) South Korea. Methods The Korean Neonatal Network (KNN) enrolled VLBWIs born between January 1, 2019 December 31, 2020. They were analyzed retrospectively duration of respiratory support, length hospitalization, mortality, short-term outcomes three groups. Results ventilator support was shorter following order: InSurE (3.99 ± 11.93 days), (8.78 29.32 Classic group (22.36 29.94 days) ( p = 0.014, < 0.01) had shortest hospitalization (64.91 24.07 days, 0.05) although results couldn't adjust confounding factor because irregular distribution. lower risk intraventricular hemorrhage (IVH) grade II–IV [odds ratio (OR) 0.524 [95% confidence interval (CI): 0.287–0.956], 0.035] than group. Mortality [OR 0.377 (95% CI: 0.146–0.978), 0.045] 0.296 0.102–0.862), 0.026] groups There a reduced moderate severe bronchopulmonary dysplasia (BPD) 0.691 0.479–0.998, 0.049), OR 0.544 0.355–0.831, 0.005), respectively], pulmonary hypertension 0.350 0.150–0.817, 0.015), 0.276 0.107–0.713, 0.008), periventricular leukomalacia (PVL) 0.382 0.187–0.780, 0.246 0.096–0.627, 0.003), patent ductus arteriosus (PDA) treatment 0.628 0.454–0.868, 0.467 0.313–0.696, 0.001) respectively] compared Conclusion showed lowest hospitalization. exhibited mortality decreased risks BPD, hypertension, PVL, PDA