Role of Surfactant by INSURE Approach in Management of Preterms with Respiratory Distress Syndrome

Surfactant replacement therapy by ‘INSURE’ is a gentle ventilatory approach in preterms with Respiratory Distress Syndrome (RDS) reducing the mortality and is associated with less adverse sequelae than mechanical ventilation. The objective of the present study is to determine the role of surfactant therapy by INSURE in reducing the mortality of preterms with RDS. 59 preterm babies with RDS were included in the study. 32 were given surfactant. 27 preterm infants who could not afford to purchase surfactant were taken as controls. There is statistically significant difference in mortality between two groups (31.5% vs 63%). The commonest cause of death in study group was sepsis (40%) and in control group was respiratory failure (41%). The mean duration of oxygen therapy, CPAP and mechanical ventilation was much less in the study group than in the control group. This study shows that INSURE is safe and cost effective intervention in reducing the mortality and need for mechanical ventilation in preterm infants with RDS.