679 - Surfactant Administration in Very Preterm Infants: A Multicenter Cohort Study in China

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 679
Publication Number: 679.443

Yanping Zhu, Xinjiang Medical University, First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China (People's Republic); Xinyue Gu, Children's Hospital of Fudan Umiversity, Shanghai, Shanghai, China (People's Republic); Siyuan Jiang, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Yun Cao, Children's Hospital of Fudan University, Shanghai, PCR, Shanghai, Shanghai, China (People's Republic); Shoo K. Lee, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada; Mingxia li, First Affiliated Hospital of Xinjiang Medical University, Urmqi, Xinjiang, China (People's Republic); Wenhao Zhou, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic)

Presenting Author(s)

YZ

Yanping Zhu (she/her/hers)

Head
Xinjiang Medical University, First Affiliated Hospital of Xinjiang Medical University
Urumqi, Xinjiang, China (People's Republic)

Background: Guidelines and practice of surfactant use among very preterm infants (VPIs, < 32 weeks gestational age (GA)) have evolved with increased use of antenatal corticosteroid treatment and early nasal continuous positive airway pressure among very preterm infants (VPIs). There is little data on surfactant treatment for VPIs in China.

Objective: To describe surfactant use among VPIs admitted to Chinese neonatal intensive care units (NICU).

Design/Methods: This multicenter cohort study included all inborn VPIs (24-31 weeks’ gestation) admitted to NICUs participating in the Chinese Neonatal Network (CHNN) from 2019 to 2021.

Results: Of the 18,264 infants enrolled, 10503(57.5%) were treated with surfactant. The proportions of VPIs treated with surfactant were 86.8% at 24-25 weeks GA, 79.4% at 26-27 weeks GA, 66.3% at 28-29 weeks GA and 43.8% at 30-31 weeks GA. A total of 9100 infants (49.8%) received one dose of surfactant, 1122 (6.1%) received 2 doses, and 218 (1.5%) received 3 or more doses. Among the 10,503 infants who received surfactant treatment, 43.9% were given the first dose within 2 hours after birth, and the percentage was higher for those at 26-27 weeks GA (50.4%) and 24-25 weeks (59.3%). There was significant inter-center variation in surfactant use among different NICUs (range 50.4% to 100% for infants < 28 weeks GA, and 25.3% to 96.4% for infants at 28-31weeks GA), which persisted after adjustment for GA.

Conclusion(s): Over 50% of VPIs received surfactant in Chinese NICUs, with high use rate among infants at 28-31 weeks’ gestation and significant inter-center variation. Continuous quality improvement initiatives are need to improve rational use of surfactant in China.