The effect of less invasive surfactant administration on cerebral oxygenation in preterm infants

Aim To determine the regional cerebral tissue oxygenation saturation (rcSO2) in a group of infants requiring less invasive surfactant administration (LISA) as compared to infants with continuous positive airway pressure (CPAP) only. Methods In preterm infants with a gestational age 26 0/7‐31 6/7 weeks, we conducted an observational study using near‐infrared spectroscopy (NIRS) in the first 120 hours of life. Results We analysed the data of 22 infants who never received surfactant (CPAP), 22 infants had LISA and CPAP (LISA) and 6 infants received surfactant via endotracheal tube (ETT). Four infants had both surfactant application modes including six LISA applications. In total, there were 32 successful LISA applications but 44 attempts; 13/44 (30%) of LISA attempts resulted in a 20% decrease of rcSO2. During the first 120 hours of life, rcSO2 values of CPAP were similar to those of infants in the LISA group, that is median rcSO2 values 90% vs 85%, respectively (P = .126). Episodes with rcSO2 values