Less invasive surfactant administration with specially designed semirigid catheter: Experience from a tertiary level neonatal unit of a lower middle-income country

Abstract

Clinical outcomes of 74 preterm neonates, who received surfactant replacement therapy (SRT), were collected retrospectively, to compare the following modes of administration: (1) less invasive surfactant administration (LISA) via a specially designed semirigid catheter (Surfcath), (2) INtubate-SURfactant-Extubate (INSURE) and (3) through endotracheal tube (ETT), in neonates requiring mechanical ventilation. The primary composite outcome of mortality or bronchopulmonary dysplasia (BPD) at 36 weeks’ post-menstrual age was 41% in LISA, 38% in INSURE and 77% in ETT groups (p < 0.01), the difference being mainly due to the high incidence of mortality in the latter. LISA, via a specially designed semirigid catheter, was safe and feasible in preterm neonates.

Keywords

MIST INSURE endotracheal tube RDS surfactant replacement therapy neonates prematurity

Get full access to this article

View all access options for this article.

References

Polin

Carlo

; Committee on Fetus and Newborn; American Academy of Pediatrics. Surfactant replacement therapy for preterm and term neonates with respiratory distress. Pediatrics. 2014;133:156–163.

Shi

Muniraman

Biniwale

, et al. A review on non-invasive respiratory support for management of respiratory distress in extremely preterm infants. Front Pediatr 2020; 8: 270.

Björklund

Ingimarsson

Curstedt

, et al. Manual ventilation with a few large breaths at birth compromises the therapeutic effect of subsequent surfactant replacement in immature lambs. Pediatr Res 1997; 42: 348–355.

Abdel-Latif

Davis

Wheeler

, et al. Surfactant therapy via thin catheter in preterm infants with or at risk of respiratory distress syndrome. Cochrane Database Syst Rev 2021; 5: CD011672.

Silahli

Tekin

. The comparison of LISA and INSURE techniques in term of neonatal morbidities and mortality among premature infants. Acta Biomed 2020; 91: e2020189.

Queliz

Perez

Corrigan

. A comparison of LISA versus InSurE: a single center experience. J Neonatal Perinatal Med 2021; 14: 503–509.

Sweet

Carnielli

Greisen

, et al. European consensus guidelines on the management of respiratory distress syndrome – 2019 update. Neonatology 2019; 115: 432–450.

Higgins

Jobe

Koso-Thomas

, et al. Bronchopulmonary dysplasia: executive summary of a workshop. J Pediatr 2018; 197: 300–308.

Jobe

Bancalari

. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001; 163: 1723–1729.

10.

Kesler

Lohmeier

Hoehn

, et al. Thin-catheter surfactant application for respiratory distress syndrome in spontaneously breathing preterm infants: a meta-analysis of randomized clinical trials. Curr Pediatr Rev 2022; 18: 286–300.

11.

Bugter

IAL

Janssen

LCE

Dieleman

, et al. Introduction of less invasive surfactant administration (LISA), impact on diagnostic and therapeutic procedures in early life: a historical cohort study. BMC Pediatr. 2020;20:421.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.02 MB