Five-year single center experience on surfactant treatment in preterm infants with respiratory distress syndrome: LISA vs INSURE

Büyüktiryaki, Mehmet; Alarcon-Martinez, Tuğba; Şimşek, Gülsüm Kadıoğlu; Canpolat, Fuat Emre; Tayman, Cüneyt; Oğuz, Şerife Suna; Kutman, Hayriye Gözde Kanmaz

doi:10.1016/j.earlhumdev.2019.06.004

Cited by 11 publications

(15 citation statements)

References 20 publications

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“…As with our study, several other trials 25–32 found no significant difference between the InSurE and LISA groups about the need for intubation within 72 h of birth. Mohammadizadeh et al 26 conducted a multicentre RCT in Iran among 38 preterm babies below 34 weeks gestational age and found insignificant difference in the need for intubation within first 72 h of life.…”

Section: Discussionsupporting

confidence: 89%

“…Mohammadizadeh et al 26 conducted a multicentre RCT in Iran among 38 preterm babies below 34 weeks gestational age and found insignificant difference in the need for intubation within first 72 h of life. Similar findings were seen in a single‐center RCT from China by Bao et al 25 However, various studies 20,29,33,34 of similar design and meta‐analysis 1,35–37 from various countries in the world have reported a significant reduction in the need for mechanical ventilation in the LISA group. Most of studies 20,29,33,34 which found significant difference in the need of MV in 72 h used nCPAP as their primary respiratory support.…”

Section: Discussionsupporting

confidence: 78%

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Surfactant administration in preterm babies (28–36 weeks) with respiratory distress syndrome: LISA versus InSurE, an open‐label randomized controlled trial

Mishra

Joshi

Londhe

et al. 2022

Pediatric Pulmonology

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Introduction INtubate‐SURfactant‐Extubate (InSurE) approach is traditional method of surfactant delivery in preterm neonates with respiratory distress syndrome (RDS). Newer, less invasive surfactant administration (LISA) techniques lessen the need for mechanical ventilation and its adverse consequences. Evidence on the favorable effects of LISA can't be extrapolated from developed to developing countries. Aim of study is to compare the effectiveness of InSurE and LISA. Objectives Primary outcome was to find need of intubation and mechanical ventilation within 72 h of birth. Neonates were followed until discharge/death for adverse events and complications. Materials and Methods Open‐label randomized controlled trial (RCT) was conducted at tertiary neonatal intensive care unit. Preterm neonates with diagnosis of RDS were randomized in two groups (InSurE or LISA) to receive surfactant soon after birth. Nasal intermittent positive pressure ventilation (NIPPV) was used as primary mode of respiratory support. Results A total of 150 neonates were analyzed (75 in each group). Insignificant statistical difference was seen in the need for intubation and mechanical ventilation within 72 h of birth between the two groups (InSurE, 30 [40%] and LISA, 30 [40%], relative risk 1.0, 95% confidence interval 0.68–1.48). Twelve percent (n = 9, LISA group) and 14.6% (n = 11 InSurE group) had adverse events during the procedure. Also, we observed insignificant statistical difference in the rates of major complications or duration of respiratory support, hospital stay, and mortality. Conclusion LISA and InSurE are equally effectiSpontaneously breathing pretermve for surfactant administration in the treatment of RDS, when NIPPV is the primary mode of respiratory support. More RCTs are required to compare the efficacy and long‐term outcomes of LISA with InSurE.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 78%

Surfactant administration in preterm babies (28–36 weeks) with respiratory distress syndrome: LISA versus InSurE, an open‐label randomized controlled trial

Mishra

Joshi

Londhe

et al. 2022

Pediatric Pulmonology

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“…However, there were still no consensus for the relationship from previous studies. Buyuktiryaki et al [ 18 ] found a significant reduction in BPD severity at 36 weeks PMA in the LISA group, compared with that in the InSurE group. Recently, Dargaville et al [ 12 ] conducted a multi-center study in infants with gestational ages between 25 and 28 weeks.…”

Section: Discussionmentioning

confidence: 99%

Effects of less invasive surfactant administration versus intubation-surfactant-extubation on bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome: a single-center, retrospective study from China

Bao

Zhao

et al. 2022

BMC Pulm Med

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Background This study evaluated the effects of less invasive surfactant administration (LISA) and intubation-surfactant-extubation (InSurE) on bronchopulmonary dysplasia (BPD) in preterm infants with respiratory distress syndrome (RDS). Methods Neonates with respiratory distress syndrome requiring surfactant, with gestational age < 32 weeks and birth weight < 1500 g admitted to our neonatal intensive care unit from January 2018 to December 2019, were retrospectively analyzed. LISA and InSurE were used independently. The incidence of BPD at 36 weeks postmenstrual age, pre-discharge mortality, and need for mechanical ventilation (MV) within 72 h of birth were compared between LISA and InSurE group. Secondary outcomes including necrotizing enterocolitis requiring surgery, retinopathy of prematurity ≥ stage 3, patent ductus arteriosus requiring medical therapy or surgery, and length of hospitalization were analyzed. Results Among the 148 included neonates, there were 46 and 102 infants in LISA group and InSurE group, respectively. There were no significant differences in BPD incidence, the severity of BPD at 36 weeks postmenstrual age, and the rate of MV within the first 72 h after birth between the two groups (P > 0.05, respectively). The incidences of necrotizing enterocolitis requiring surgery, retinopathy of prematurity ≥ stage 3, patent ductus arteriosus requiring medical therapy or surgery, and length of hospitalization did not differ significantly between the two groups (P > 0.05, respectively). Conclusions For surfactant administration among preterm infants with respiratory distress syndrome, LISA did not decrease bronchopulmonary dysplasia and severity of BPD at 36 weeks postmenstrual age. The benefits of LISA would require further evaluations.

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“…Curosurf may be preferred in bigger infants since higher concentration can be delivered by administering low intratracheal volume. Majority of the trials have used 100 mg/kg surfactant 15,19,20,26,29,33–35 while a few have used higher doses of 200 mg/kg of surfactant 22,23,25,28,32,36,65 . Many units in routine practice as well as authors in the NINSAP trial 31 have used whole vial policy delivering higher dose of around 150 mg/kg in extreme preterm neonates 66,67 .…”

Section: Srt Using Thin Cathetersmentioning

confidence: 99%

“…Need for MV within 72 h of life has been reported to be significantly less with thin catheter technique in majority of the studies 15,16,20,22,23,25,27,29,31,34,35,48,53,55,59,62,65 …”

Section: Short‐term Outcomesmentioning

confidence: 99%

Surfactant delivery via thin catheters: Methods, limitations, and outcomes

Devi

Pandita

2021

Pediatric Pulmonology

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Various less invasive surfactant administration strategies like surfactant replacement therapy via thin catheters, laryngeal mask airway, pharyngeal instillation, and nebulized surfactant are increasingly being practiced to avoid the harmful effects of endotracheal intubation and ventilation. Numerous studies have been done to study surfactant replacement via thin catheters whereas little data is available for other methods. However, there are variations in premedication policies, type of respiratory support used in these studies. Surfactant delivery using thin catheters has been reported to be associated with decrease in the need for mechanical ventilation (MV), duration of MV, bronchopulmonary dysplasia and neonatal mortality. With the current evidence, among all the available surfactant delivery methods, the one using thin catheters appears to be the most feasible and beneficial to improve clinical neonatal outcomes.

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Five-year single center experience on surfactant treatment in preterm infants with respiratory distress syndrome: LISA vs INSURE

Cited by 11 publications

References 20 publications

Surfactant administration in preterm babies (28–36 weeks) with respiratory distress syndrome: LISA versus InSurE, an open‐label randomized controlled trial

Surfactant administration in preterm babies (28–36 weeks) with respiratory distress syndrome: LISA versus InSurE, an open‐label randomized controlled trial

Effects of less invasive surfactant administration versus intubation-surfactant-extubation on bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome: a single-center, retrospective study from China

Surfactant delivery via thin catheters: Methods, limitations, and outcomes

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