Response to Aerosolized Calfactant in Infants with Respiratory Distress Syndrome; A Post-hoc Analysis of AERO-02 trial

Abstract Background The largest randomized control trial of aerosolized surfactant (AERO-02 trial) demonstrated a reduction in intubation by 50%. Objective To determine the response after aerosolized calfactant treatment. Methods We conducted a post-hoc analysis of moderate to late preterm neonates in the AERO-02 trial. Trends in hourly fraction of oxygen (FiO2), mean airway pressure (MAP) and respiratory severity score (RSS) were compared between the aerosolized surfactant (AS) and usual care (UC) groups. Results Forty-eight percent of subjects in the UC group required intubation compared to 24% in the AS group. FiO2, MAP and RSS were lower in the UC group. FiO2 decrease was seen after the first aerosolized calfactant dose. Conclusion FiO2, MAP and RSS were lower in the UC group. This is likely due to early and higher rate of liquid surfactant administration in the UC group. Decrease in FiO2 was noted in the AS group after the first aerosolization.