• About Us
    • Contact Us
    • Login
    • ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
About Us Contact Us Login ObGFirst
  • COVID-19
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • Now@ObG
  • Media
Grand Rounds

RCT Results: Can Aerosolized Calfactant Reduce the Need for Intubation in Newborns with RDS?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • For newborns with respiratory distress syndrome (RDS), surfactant treatment requires intubation and is often followed by positive pressure ventilation
    • Aerosol delivery would be safer, but clinical studies have been inconclusive
  • Cummings et al. (Pediatrics, 2020) examined whether efficient aerosolization of a surfactant early in the course of RDS could reduce the need for intubation and instillation of liquid surfactant

METHODS:

  • Prospective, multicenter, randomized, unblinded comparison trial
  • Participants
    • Newborns with signs of RDS that required noninvasive respiratory support
  • Interventions
    • Usual care, as determined by provider
    • Aerosolized calfactant (calf-derived surfactant)
      • Calfactant was aerosolized using a nebulizer
      • 6 mL/kg (210 mg phospholipid/kg body weight) delivered directly into the mouth
      • Infants received up to 3 treatments, at least 4 hours apart
  • Study design
    • Infants were intubated and given instilled surfactant for persistent or worsening respiratory distress (clinicians’ discretion)

RESULTS:

  • 457 infants | 230 infants in aerosol group 
    • Gestation: 23 to 41 (median 33) weeks
    • Birth weight: 595 to 4802 (median 1960) grams
  • 225 of the infants in the aerosol group received 334 treatments, starting at median 5 hours
  • Rate of intubation for surfactant instillation were significantly decreased in the aerosol group (P < 0.0001)
    • Aerosol: 26%
    • Usual care: 50%
  • There was no difference in respiratory outcomes up to 28 days of age

CONCLUSION:

  • Aerosolized calfactant reduced the need for intubation and surfactant instillation by nearly one-half in newborns with early, mild to moderate respiratory distress
  • An accompanying editorial concludes that the results are promising and may help avoid intubation currently required for standard surfactant use
    • However, study limitations include lack of blinding and pragmatic approach that would allow for multiple different management scenarios across multiple sites

Learn More – Primary Sources:

Aerosolized Calfactant for Newborns With Respiratory Distress: A Randomized Trial

Aerosolized Calfactant in Infants With RDS: Surfactant Replacement 2.0?

Now You Can Get ObG Clinical Research Summaries Direct to Your Phone, with ObGFirst

ObGFirst® – Try It Free! »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Fetal Lung Mass – Best Predictors of Newborn Respiratory Distress?
Does GDM Independently Increase Risk for Neonatal Respiratory Morbidity?
Do Antenatal Corticosteroids Reduce Morbidity in Premature Neonates Prior to 24 weeks?

Sections

  • COVID-19
  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • Now@ObG
  • Media

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Get Guideline Alerts Direct to Your Phone
Try ObGFirst Free!

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site