Cardiovascular response and sequelae after minimally invasive surfactant therapy in growth-restricted preterm infants.

Abstract

Objective: To study cardiovascular response to minimally invasive surfactant therapy in preterm infants with and without foetal growth restriction (FGR). Design(s): Poractant alfa was administered and echocardiograms were performed before and 30 min after. FGR infants were compared with those appropriate for gestational age (AGA). Result(s): Ten FGR infants were compared with 20 AGA infants (gestation [weeks], 28.9 +/- 2 vs. 28.6 +/- 1, p = 0.55 and birthweight [g], 813 +/- 157 vs. 1141 +/- 257, p = 0.01, respectively). The change in echocardiographic parameters was more prominent in AGA infants ([global contractility] fractional area change [FAC, %], FGR, 24.7 +/- 2.2 to 27.9 +/- 0.4, p = 0.08 vs. AGA, 26.6 +/- 3 to 30.5 +/- 1, p < 0.01, and [longitudinal contractility] tricuspid annular plane systolic excursion [mm], FGR, 3.9 +/- 0.3 to 4.6 +/- 0.5, p = 0.003 vs. AGA, 4.6 +/- 0.3 to 5.5 +/- 0.4, p = 0.0001). Significant difference was noted for change in FAC (%), FGR 2.1 +/- 1.7 vs. AGA 4.1 +/- 1.2, p = 0.02. Conclusion(s): Differential cardiovascular response to minimally invasive surfactant therapy amongst FGR infants may reflect an in-utero maladaptive state.Copyright © 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.