Comparative analysis between invasive and non-invasive surfactant administration methods in preterm infants at the Neonatology Unit of the Hospital Metropolitano, during the period from January 1, 2014, to October 31, 2024
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Abstract
Introduction: Hyaline membrane disease (HMD) is traditionally treated using conventional invasive methods (CIM), such as the INSURE technique and endotracheal intubation, or minimally invasive methods like the LISA technique. This study evaluates whether surfactant administration via LISA reduces the need for invasive mechanical ventilation (IMV) within the first 72 hours of life. It also compares oxygen dependence at discharge, at 28 days, and at 36 weeks of corrected gestational age, as well as hospital stay duration and mortality. Methodology: An observational, analytical, and retrospective study was conducted, including 114 preterm infants admitted to the Neonatology Unit of the Hospital Metropolitano between January 1, 2014, and October 31, 2024. Results: Of the total sample, 37.7% received treatment via LISA and 62.2% via CIM. The LISA-treated group showed significantly favorable outcomes: Mechanical ventilation (first 72 hours): Drastic reduction compared to CIM (14% vs. 92%, p < 0.001). Statistical analysis (IMV): An absolute risk reduction (ARR) of 78% (95% CI: 65%-90%), a relative risk (RR) of 0.15 (95% CI: 0.07-0.32), and a number needed to treat (NNT) of 1.29 (95% CI: 1.11-1.53) were observed. Oxygen therapy and Mortality: LISA was associated with lower oxygen dependence at week 36 (63% vs. 86%) and lower hospital mortality (2% vs. 30%). Intubation: The LISA group required less intubation at birth compared to the CIM group (where it reached 53%). No statistically significant differences were found in the length of hospital stay between the two groups. Conclusion: The LISA technique proved to be superior to conventional invasive methods by significantly reducing the need for mechanical ventilation in the first 72 hours, oxygen dependence at week 36, the initial intubation rate, and hospital mortality, without affecting the duration of hospital stay.
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