A multicenter study on vibrating mesh nebulization of pulmonary surfactant for treating respiratory distress syndrome in preterm infants
- 1Department of Pediatrics, First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233004, China
Abstract
ObjectiveTo evaluate the efficacy of noninvasive ventilation combined with vibrating mesh nebulization of pulmonary surfactant (PS) in preterm infants with respiratory distress syndrome (RDS) and to identify predictors of treatment failure.MethodsPreterm infants with RDS (gestational age >28 weeks, birth weight >1 000 g) admitted to neonatal intensive care units at 12 hospitals between June 2023 and November 2024 were prospectively enrolled. All infants initially received nasal continuous positive airway pressure and were treated with PS administered via vibrating mesh nebulization. Infants were categorized into a success group or a failure group according to whether escalation to invasive mechanical ventilation via endotracheal intubation was required. Multivariable logistic regression was used to identify predictors of failure of vibrating mesh nebulized PS treatment. A prediction model was constructed, and its performance was assessed using receiver operating characteristic (ROC) curves and the area under the curve (AUC).ResultsA total of 126 preterm infants with RDS were included, with 107 (84.9%) in the success group and 19 (15.1%) in the failure group. Multivariable logistic regression analysis showed that nonstandard antenatal glucocorticoid use, a lower 1-minute Apgar score, chest radiograph showing RDS grade ≥III, and a lower ratio of partial pressure of arterial oxygen (PaO2) to fraction of inspired oxygen (FiO2) (PaO2/FiO2) at 30 minutes after treatment were independent predictors of treatment failure (P<0.05). The prediction model for treatment failure based on these four factors yielded an AUC of 0.857 (95%CI: 0.789-0.943), with a sensitivity of 84.21% and a specificity of 74.53%. The cutoff values for the 1-minute Apgar score and PaO2/FiO2 at 30 minutes after treatment were <8 and <220 mmHg, respectively.ConclusionsNoninvasive ventilation combined with vibrating mesh nebulization of PS achieves a high success rate in preterm infants with RDS who had a gestational age >28 weeks and a birth weight >1 000 g. Nonstandard antenatal glucocorticoid use, a 1-minute Apgar score <8, chest radiograph showing RDS grade ≥III, and PaO2/FiO2 <220 mmHg at 30 minutes after treatment are independent predictors of treatment failure.
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BibTeX
@article{yumeng2026multicenter,
title = {{A multicenter study on vibrating mesh nebulization of pulmonary surfactant for treating respiratory distress syndrome in preterm infants}},
author = {WU Yu-Meng and CHEN Xin and LI Ru-Na and SUN Si-Ying and RAO Rui and YANG Lu-Ling and JIANG Xiao-Hong and XU Xue-Tao and WANG Hui and WANG Han-Qing and ZHANG Yin-Long and LIU Mei and ZHANG Ya-Li and GUO Qian and LI Jin-Hong and LI De-Xin and WANG Bo and LUO Hou-Jiang and YANG Jun and FENG Min and XIE Shi-Di and XU Hong and ZOU Qiao-Qiao and SUN Dan and SHI Lei and WAN Hong and WANG Zi-Ang},
journal = {中国当代儿科杂志},
year = {2026},
month = oct,
doi = {10.7499/j.issn.1008-8830.2601004},
url = {https://doi.org/10.7499/j.issn.1008-8830.2601004},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - A multicenter study on vibrating mesh nebulization of pulmonary surfactant for treating respiratory distress syndrome in preterm infants
AU - WU Yu-Meng
AU - CHEN Xin
AU - LI Ru-Na
AU - SUN Si-Ying
AU - RAO Rui
AU - YANG Lu-Ling
AU - JIANG Xiao-Hong
AU - XU Xue-Tao
AU - WANG Hui
AU - WANG Han-Qing
AU - ZHANG Yin-Long
AU - LIU Mei
AU - ZHANG Ya-Li
AU - GUO Qian
AU - LI Jin-Hong
AU - LI De-Xin
AU - WANG Bo
AU - LUO Hou-Jiang
AU - YANG Jun
AU - FENG Min
AU - XIE Shi-Di
AU - XU Hong
AU - ZOU Qiao-Qiao
AU - SUN Dan
AU - SHI Lei
AU - WAN Hong
AU - WANG Zi-Ang
PY - 2026
DA - 2026/10/23
JO - 中国当代儿科杂志
DO - 10.7499/j.issn.1008-8830.2601004
UR - https://doi.org/10.7499/j.issn.1008-8830.2601004
AB - ObjectiveTo evaluate the efficacy of noninvasive ventilation combined with vibrating mesh nebulization of pulmonary surfactant (PS) in preterm infants with respiratory distress syndrome (RDS) and to identify predictors of treatment failure.MethodsPreterm infants with RDS (gestational age >28 weeks, birth weight >1 000 g) admitted to neonatal intensive care units at 12 hospitals between June 2023 and November 2024 were prospectively enrolled. All infants initially received nasal continuous positive airway pressure and were treated with PS administered via vibrating mesh nebulization. Infants were categorized into a success group or a failure group according to whether escalation to invasive mechanical ventilation via endotracheal intubation was required. Multivariable logistic regression was used to identify predictors of failure of vibrating mesh nebulized PS treatment. A prediction model was constructed, and its performance was assessed using receiver operating characteristic (ROC) curves and the area under the curve (AUC).ResultsA total of 126 preterm infants with RDS were included, with 107 (84.9%) in the success group and 19 (15.1%) in the failure group. Multivariable logistic regression analysis showed that nonstandard antenatal glucocorticoid use, a lower 1-minute Apgar score, chest radiograph showing RDS grade ≥III, and a lower ratio of partial pressure of arterial oxygen (PaO2) to fraction of inspired oxygen (FiO2) (PaO2/FiO2) at 30 minutes after treatment were independent predictors of treatment failure (P<0.05). The prediction model for treatment failure based on these four factors yielded an AUC of 0.857 (95%CI: 0.789-0.943), with a sensitivity of 84.21% and a specificity of 74.53%. The cutoff values for the 1-minute Apgar score and PaO2/FiO2 at 30 minutes after treatment were <8 and <220 mmHg, respectively.ConclusionsNoninvasive ventilation combined with vibrating mesh nebulization of PS achieves a high success rate in preterm infants with RDS who had a gestational age >28 weeks and a birth weight >1 000 g. Nonstandard antenatal glucocorticoid use, a 1-minute Apgar score <8, chest radiograph showing RDS grade ≥III, and PaO2/FiO2 <220 mmHg at 30 minutes after treatment are independent predictors of treatment failure.
SN - 1008-8830
SN - 2096-9228
ER -