Background and aims Respiratory Distress Syndrome is the most frequent cause of respiratory insufficiency in premature infants. The essentials of INSURE therapy are INtubation after noticing the condition of RDS, SURfactant therapy and Extubation to non-invasive respiration. At our ward INSURE therapy was introduced in 2012.
Patients and methods We analysed our patients who received INSURE therapy during the 21-month-long period from July 1. 2012 until March 31. 2014. INSURE therapy was considered effective, if the patient did not require invasive ventilation within 1 week. During the examined period 398 patients were admitted to our 18-bed tertiary Neonatal Intensive Care Unit. INSURE therapy was applied in the case of 82 prematures (gestational age: 29 ± 3 weeks, birthweight 1358 ± 404 g; mean±SD).
Results A surfactant (Curosurf ®) dose of 168 ± 39 mg/kg was administered. There was no need for repeated intubation in 57 cases, in 13 cases a second dose was surfactant was also necessary. In 21/82 cases INSURE was not successful. In the unsuccessful group patients were not significantly younger and smaller. Procalcitonin levels at the age of one day were significantly higher the group of unsuccessful cases. III-IV Gr. IVH occurred in 6/82 necrotizing enterocolitis in 7/82 and bronchopulmonary dysplasia in 7/82 cases. Complications were more frequent in those cases whose INSURE therapy was unsuccessful.
Conclusions The introduction of INSURE-therapy grossly decreased the need for invasive respiratory support. High procalcitonin levels and clinical manifestations of early neonatal infections as well as low birth weight negatively influenced the success of INSURE-therapy.