The Incubator #386 - 🟢 HOT TOPICS 2025 COVERAGE - Should Late Preterm Infants Receive Early Surfactant for Respiratory Distress?
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Dec 9, 2025 Dr. Elaine Boyle discusses the SURFON trial, which evaluates the use of early surfactant in late preterm infants with respiratory distress. Findings reveal no significant difference in hospital stays or severe respiratory disease progression. However, early surfactant slightly reduces NICU time and non-invasive support duration. Safety concerns arise with an increase in pneumothorax cases, prompting ongoing research for this vulnerable group. The conversation highlights the need for mindful approaches in managing late preterm infants.
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Close-To-Term Still Vulnerable
- Late preterm and early term infants commonly develop respiratory distress despite near-term gestation.
- Their lung immaturity means many will have RDS or other causes needing attention beyond watchful waiting.
Clinician Frustration Sparked The Trial
- Dr. Elaine Boyle described frustration watching larger infants remain on CPAP and oxygen without active treatment.
- She worried about separation from mothers, prolonged work of breathing, and delayed feeding for these babies.
Make Trials Pragmatic And Clinically Relevant
- Design pragmatic trials that match real-world practice to gain clinician buy-in.
- Include eligibility reflecting both oxygen needs and clinician judgment of work of breathing.