Análisis comparativo entre métodos de administración de surfactante invasivos y no invasivos en recién nacidos prematuros de la unidad de Neonatología del Hospital Metropolitano, durante el período 1 Enero 2014 a 31 de octubre de 2024
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La enfermedad de membrana hialina (EMH) es tratada mediante la aplicación de surfactante por métodos invasivos convencionales (MIC): INSURE e intubación endotraqueal y no invasivos: LISA. Este estudio evalúa si LISA reduce la ventilación mecánica invasiva en las primeras 72 horas y compara la necesidad de oxígeno al alta, a los 28 días, a la semana 36, el tiempo de hospitalización y la mortalidad hospitalaria entre ambos grupos. Métodos: estudio observacional, analítico, retrospectivo, se analizaron registros de 114 recién nacidos prematuros ingresados en la unidad de Neonatología del Hospital Metropolitano durante el período del 1 de enero de 2014 al 31 de octubre de 2024. Resultados: 37.7% recibieron LISA y 62.2% MIC. LISA se asoció con menor necesidad de oxígeno a la semana 36 (63% vs. 86%), menor mortalidad hospitalaria (2% vs. 30%) y menor intubación al nacer (53% en MIC). La ventilación invasiva en las primeras 72 horas fue menor en el grupo LISA (14% vs. 92%, p < 0.001). LISA mostró una reducción significativa en la necesidad de ventilación mecánica invasiva en las primeras 72 horas de vida, con una reducción absoluta del riesgo del 78% (IC 95%: 65%- 90%), un riesgo relativo de 0.15 (IC 95%: 0.07-0.32) y un número necesario a tratar de 1.29 (IC 95%: 1.11-1.53). Conclusión: LISA redujo notablemente la necesidad de ventilación mecánica en las primeras 72 horas, oxígeno a la semana 36, intubación al nacer y mortalidad, sin influir en la duración de hospitalización, comparado con métodos invasivos como INSURE e intubación.
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