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Am J Perinatol 2022; 39(05): 562-566
DOI: 10.1055/s-0040-1715821
Short Communication

Pharmaceutical Expenditure Is Unchanged with Ultrasound-Guided Surfactant Administration

Daniele De Luca 
1   Division of Paediatrics and Neonatal Critical Care, “A. Béclère” Medical Centre, Paris Saclay University Hospitals, AP-HP, Paris, France
2   Physiopathology and Therapeutic Innovation Unit, Paris–Saclay University, Paris, France
,
Nadya Yousef 
1   Division of Paediatrics and Neonatal Critical Care, “A. Béclère” Medical Centre, Paris Saclay University Hospitals, AP-HP, Paris, France
› Author Affiliations Funding None.
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Abstract

Objective Semiquantitative lung ultrasound improves the timeliness of surfactant replacement, but its financial consequences are unknown. We aim to investigate if the ultrasound-guided surfactant administration influences the general costs of surfactant therapy for preterm neonates affected by respiratory distress syndrome.

Study Design This is a pharmacoeconomic, retrospective, and before-and-after study investigating the impact of ultrasound-guided surfactant replacement (echography-guided Surfactant THERapy [ESTHER]) on pharmaceutical expenditure within the ESTHER initiative. Data extracted from the institutional official database hosted by the hospital administration for financial management were used for the analysis. We analyzed the number of surfactant administrations in neonates of gestational age ≤326/7 weeks, and the number of surfactant vials used from January 1, 2014 to June 30, 2014 (i.e., during the period of standard surfactant administration policy) and from July 1, 2016 to December 31, 2018 (that is during ESTHER policy).

Results ESTHER did not modify surfactant use, as proportion of treated neonates with RDS receiving at least one surfactant dose (Standard: 21.3% vs. ESTHER: 20.9%; p = 0.876) or as proportion of used vials over the total number of vials opened for neonates of any gestational age (Standard: 37% vs. ESTHER: 35%; p = 0.509).

Conclusion Ultrasound-guided surfactant replacement using a semiquantitative lung ultrasound score in preterm infants with RDS does not change the global use of surfactant and the related expenditure.

Key Points

  • ESTHER is able to increase the timeliness of surfactant replacement.

  • The ultrasound-guided surfactant administration does not increase the cost of surfactant therapy.

  • The ultrasound-guided surfactant administration does not change the global surfactant utilization.

Keywords

lung ultrasound - surfactant - preterm neonate - respiratory distress syndrome

Note

The results of this study were never presented in any meeting abstract.


Authors' Contributions

Both authors are guarantors and take responsibility for the manuscript content. D.D.L. and N.Y. equally contributed to study conception and design. They drafted the article and revised it for important intellectual content. D.D.L. performed the data analysis and supervised the whole project. Both authors approved the final version to be published.




Publication History

Received: 21 May 2020

Accepted: 20 July 2020

Article published online:
20 August 2020

© 2020. Thieme. All rights reserved.

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  • References

  • 1 Raimondi F, Yousef N, Migliaro F, Capasso L, De Luca D. Point-of-care lung ultrasound in neonatology: classification into descriptive and functional applications. Pediatr Res 2021; 90 (03) 524-534
    CrossrefPubMedGoogle Scholar
  • 2 Brat R, Yousef N, Klifa R, Reynaud S, Shankar Aguilera S, De Luca D. Lung ultrasonography score to evaluate oxygenation and surfactant need in neonates treated with continuous positive airway pressure. JAMA Pediatr 2015; 169 (08) e151797
    CrossrefPubMedGoogle Scholar
  • 3 De Martino L, Yousef N, Ben-Ammar R, Raimondi F, Shankar-Aguilera S, De Luca D. Lung ultrasound score predicts surfactant need in extremely preterm neonates. Pediatrics 2018; 142 (03) e20180463
    CrossrefPubMedGoogle Scholar
  • 4 Razak A, Faden M. Neonatal lung ultrasonography to evaluate need for surfactant or mechanical ventilation: a systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed 2020; 105 (02) 164-171
    CrossrefPubMedGoogle Scholar
  • 5 Raschetti R, Yousef N, Vigo G. et al. Echography-guided surfactant therapy to improve timeliness of surfactant replacement: a quality improvement project. J Pediatr 2019; 212: 137-143.e1
    CrossrefPubMedGoogle Scholar
  • 6 Cogo PE, Facco M, Simonato M. et al. Pharmacokinetics and clinical predictors of surfactant redosing in respiratory distress syndrome. Intensive Care Med 2011; 37 (03) 510-517
    CrossrefPubMedGoogle Scholar
  • 7 Escourrou G, De Luca D. Lung ultrasound decreased radiation exposure in preterm infants in a neonatal intensive care unit. Acta Paediatr 2016; 105 (05) e237-e239
    CrossrefPubMedGoogle Scholar
  • 8 Zieleskiewicz L, Cornesse A, Hammad E. et al. Implementation of lung ultrasound in polyvalent intensive care unit: impact on irradiation and medical cost. Anaesth Crit Care Pain Med 2015; 34 (01) 41-44
    CrossrefPubMedGoogle Scholar
  • 9 Raimondi F, Yousef N, Rodriguez Fanjul J. et al. A multicenter lung ultrasound study on transient tachypnea of the neonate. Neonatology 2019; 115 (03) 263-268
    CrossrefPubMedGoogle Scholar