Early INSURE Therapy Reduces CPAP Failure in Late Preterm Newborns with Respiratory Distress Syndrome

Background: INSURE (Intubation, Surfactant administration, and Extubation) therapy is controversial in managing respiratory distress syndrome (RDS) late preterm newborns. This study aims to determine whether the use of infants with RDS associated improved outcomes compared similar managed CPAP alone. Methods: A retrospective cohort two different neonatal care units treatments Bucaramanga, Colombia. One used selective bubble rescue surfactant, second within first hour life. We included all newborns gestational age between 33 - 366/7 weeks, born 2012 2017, that developed early were treated CPAP. Results: recruited 208 patients (57 surfactant 151 + INSURE). Early was reported 117 (56.3 %). a reduced risk failure (RR = 0.50; 95 % CI 0.26 0.98); this effect evident only when administered hours life 0.29; 0.12 0.69). decreased pneumothorax 0.07; 0.01 0.77) pulmonary hypertension 0.34; 0.14 0.78). Conclusions: incidence failure, pneumothorax, moderate severe RDS. Large, well-powered randomized controlled trials are needed confirm these observations, but its supported by studies results more premature infants.