AimTo review the initial effectiveness of bovine lipid extract surfactant (BLES) for the treatment of respiratory distress syndrome in preterm infants.Methods and resultsA retrospective review of data collected from infants born <37‐week gestation with respiratory distress syndrome treated with BLES between February 1, 2015 and March 1, 2016. Data were analyzed to determine the timing of initial dose, the length of time to wean the fraction of inspired oxygen (FiO2) concentration to 0.21 following initial dose, and the number of repeated doses given during hospital admission. Infants were subgrouped by gestational age stratum, 230 to 276 weeks (group 1), 280 to 316 weeks (group 2), and 320 to 366 weeks (group 3). Ninety‐eight infants received the surfactant during the study period. After applying exclusion criteria, 77 infants were analyzed. Mean (SD) gestational age was 28 (4) weeks, and mean (SD) birth weight was 1250 (602) g. Initial dose of BLES was given at a median (interquartile range) time of 29 (19‐43) minutes in group 1, 150 (20‐615) minutes in group 2, and 990 (53‐2025) minutes in group 3. Median (interquartile range) length of time to wean the FiO2 concentration to 0.21 was 14 (5‐56) minutes, 10 (5‐53) minutes, and 10 (5‐38) minutes in groups 1, 2, and 3, respectively. Ten infants required repeated doses.ConclusionGiven the rapid response of BLES in all the groups, careful monitoring of ventilator parameters is paramount to allow for rapid weaning and early extubation to avoid lung injury associated with mechanical ventilation.

parental projection of QOL. Perspectives from a cohort of parents of neonates at risk of severe neurodevelopmental outcome as defined by follow-up referral criteria (<29 weeks, Sarnat 2, IVH 3, PVL, severe neurological condition, severe genetic abnormality, exchange transfusion, ROP 3, diaphragmatic hernia or any condition having significant neurological impact) were compared with a control group including parents of all other neonates admitted to the NICU. Questions include likert scales (1 to 7) and yes/no answers. Variables were analyzed using Chi 2 test. RESULTS: 107 questionnaires were returned (88%). 58 (54%) cohort group and 49 (45%) control. Both groups had similar income and level of education. Parents of cohort group projected more long term financial impact on the family (p=0.012). There were no statistical differences between the groups on projections of: physical and mental difficulties, pain and discomfort, longevity of life, having a chronic condition, feeling of difference and ability to cope, happiness and QOL, role in society, having friends and a family, ability to live alone and emotional impact on the family. Both group had low concernson perspective of risk of long term physical and mental difficulties, pain or child feeling different (mean score 1.7-2 out of 7), and rated high on childs happiness, QOL and ability to cope (mean score 6.4-6.6 out of 7). Both cohort and control groups envisioned sequelae with moderate rating on emotional impact on the family (mean score 2.4-3.2 out of 7). 100% of parents projected that their child would be self-sufficient for activities of daily living and able to find employment. CONCLUSION: Parental projection of future QOL of infants hospitalized in NICU is not associated with known risks of neurodevelopmental sequelae. Most parents predict overall a good future quality of life for their child. Parental concerns focused more on the impact on the family.