Less invasive surfactant administration reduces incidence of severe intraventricular haemorrage in preterms with respiratory distress syndrome: a cohort study

Pérez-Iranzo, Antonio; Jarque, A; Toledo, Juan Diego; Tosca, Ricardo

doi:10.1038/s41372-020-0702-5

Cited by 8 publications

(2 citation statements)

References 39 publications

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“…Decreased IVH/PVL with thin catheter technique has been reported by many studies 26,31,79,80 One of the possible explanations is decreased fluctuations in blood pressure and cerebral blood flow, lower incidence of hypocarbia with thin catheter technique in preterm babies with poor autoregulation and fragile germinal matrix. These fluctuations will be higher with mechanical breaths 79 …”

Section: Short‐term Outcomesmentioning

confidence: 95%

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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Section: Short‐term Outcomesmentioning

confidence: 95%

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

Devi

Pandita

2021

Pediatric Pulmonology

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“…In many studies, the use of a thin catheter technique for SF administration has been associated with lower rates and severity of brain injury (intraventricular hemorrhage/periventricular leukomalacia) and better neurodevelopmental outcomes in infants [3,30,31], probably due to few episodes of hypoxia, and less fluctuation in blood pressure and cerebral blood flow [32]. Moreover, such a technique may protect preterm infants against adverse neurodevelopmental outcomes at 18 months observed after prolonged hypoxemia [8].…”

Section: Plos Onementioning

confidence: 99%

Structural and haemodynamic evaluation of less invasive surfactant administration during nasal intermittent positive pressure ventilation in surfactant-deficient newborn piglets

et al. 2023

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The most recent approaches to the initial treatment of respiratory distress syndrome (RDS)- involve non-invasive ventilation (NIV) and less-invasive surfactant (SF) administration (LISA). Combining these techniques has been proven a useful treatment option for SF-deficient neonates. The objective of this study was to explore the impact on the brain (using cerebral near infrared spectroscopy, NIRS) of different LISA methods during NIV, using nasal intermittent positive pressure ventilation (NIPPV) for treating neonatal RDS. For this, we used five groups of spontaneously breathing newborn piglets (n = 6/group) with bronchoalveolar lavage (BAL)-induced respiratory distress which received NIPPV only (controls), poractant-alfa using the INSURE-like method (bolus delivery) followed by NIPPV, or poractant-alfa using one of three LISA devices, 1) a nasogastric tube (NT), 2) a vascular catheter (VC) or 3) the LISAcath® catheter. We assessed pulmonary, hemodynamic and cerebral effects, and performed histological analysis of lung and brain tissue. Following BALs, the piglets developed severe RDS (pH<7.2, PaCO2>70 mmHg, PaO2<70 mmHg, dynamic compliance<0.5 ml/cmH2O/kg at FiO2 = 1). Poractant-alfa administration using different LISA techniques during NIPPV was well tolerated and efficacious in newborn piglets. In our study, although all groups showed normal physiological ranges of total lung injury score and biochemical lung analysis, VC and LISAcath® catheters were associated with better values of lung compliance and lower values of lung damage than NIPPV, NT or INSURE-like methods. Moreover, neither of the SF administration methods used (LISA or INSURE-like) had a significant impact on the histological neonatal brain injury score. Of note, the LISAcath® has been recently withdrawn from the market.

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