Minimally invasive surfactant therapy
            <i>versus</i>
            intubation for surfactant delivery in preterm infant with RDS: evaluation of safety and efficacy

Elbaz, Yedidiel; Portnov, Igor; Lurie-Marcu, Bela; Shinwell, Eric S.

doi:10.1080/14767058.2021.1924145

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…LISA and MIST have similar methods of surfactant administration, which can avoid the complications of the InSurE and Classic methods; thus, LISA and MIST are currently used interchangeably. LISA is a technique that can avoid the need for endotracheal intubation and PPV and has been shown to reduce the need for mechanical ventilation ( 7 , 11 , 12 ). LISA is expected to reduce lung injury due to barotrauma and volutrauma, thereby preventing the evolution of BPD ( 12 – 16 ).…”

Section: Introductionmentioning

confidence: 99%

Comparison of mortality and short-term outcomes between classic, intubation-surfactant-extubation, and less invasive surfactant administration methods of surfactant replacement therapy

Kim,

Lim,

Shim

2023

Front. Pediatr.

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BackgroundIntubation-Surfactant-Extubation (InSurE) and less invasive surfactant administration (LISA) are alternative surfactant replacement therapy methods for reducing the complications associated with invasive mechanical ventilation. This study aimed to compare the Classic, InSurE, and LISA methods in Very-Low-Birth-Weight infants (VLBWIs) in South Korea.MethodsThe Korean Neonatal Network (KNN) enrolled VLBWIs born between January 1, 2019 and December 31, 2020. They were analyzed retrospectively to compare the duration of respiratory support, length of hospitalization, mortality, and short-term outcomes of the three groups.ResultsThe duration of invasive ventilator support was shorter in the following order: InSurE (3.99 ± 11.93 days), LISA (8.78 ± 29.32 days), and the Classic group (22.36 ± 29.94 days) (p = 0.014, p < 0.01) and InSurE had the shortest hospitalization (64.91 ± 24.07 days, p < 0.05) although the results couldn't adjust for confounding factor because of irregular distribution. InSurE had the lower risk of intraventricular hemorrhage (IVH) grade II–IV [odds ratio (OR) 0.524 [95% confidence interval (CI): 0.287–0.956], p = 0.035] than in the Classic group. Mortality was lower in the InSurE [OR 0.377 (95% CI: 0.146–0.978), p = 0.045] and LISA [OR 0.296 (95% CI: 0.102–0.862), p = 0.026] groups than in the Classic group. There was a reduced risk of moderate to severe bronchopulmonary dysplasia (BPD) [OR 0.691 (95% CI: 0.479–0.998, p = 0.049), OR 0.544 (95% CI: 0.355–0.831, p = 0.005), respectively], pulmonary hypertension [OR 0.350 (95% CI: 0.150–0.817, p = 0.015), OR 0.276 (95% CI: 0.107–0.713, p = 0.008), respectively], periventricular leukomalacia (PVL) [OR 0.382 (95% CI: 0.187–0.780, p = 0.008), OR 0.246 (95% CI: 0.096–0.627, p = 0.003), respectively], and patent ductus arteriosus (PDA) with treatment [OR 0.628 (95% CI: 0.454–0.868, p = 0.005), OR 0.467 (95% CI: 0.313–0.696, p < 0.001) respectively] in the InSurE and LISA groups compared to the Classic group.ConclusionInSurE showed the lowest duration of invasive ventilator support, length of hospitalization. InSurE and LISA exhibited reduced mortality and decreased risks of moderate to severe BPD, pulmonary hypertension, PVL, and PDA with treatment compared to the Classic group.

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Section: Introductionmentioning

confidence: 99%

Comparison of mortality and short-term outcomes between classic, intubation-surfactant-extubation, and less invasive surfactant administration methods of surfactant replacement therapy

Kim,

Lim,

Shim

2023

Front. Pediatr.

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“…The centers that participated in the trials performed the LISA procedure according to different local protocols [ 9 ], one of the studies’ concerns. Several studies have shown that the introduction of LISA had positive effects compared with historical comparison groups treated conventionally, including reductions in the need for oxygen, mechanical ventilation, and surfactant [ 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Improved Less Invasive Surfactant Administration Success in Preterm Infants after Procedure Standardization

et al. 2021

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Less invasive surfactant administration (LISA) has been introduced at our tertiary Level IV perinatal center since 2016 with an unsatisfactory success rate, which we attributed to an inconsistent, non-standardized approach and ambiguous patient inclusion criteria. This study aimed to improve the LISA success rate to at least 75% within 12 months by implementing a highly standardized LISA approach combined with team training. The Plan Do Study Act method of quality improvement was used for this initiative. Baseline assessment included a review of patient medical records 12 months before the intervention regarding patient characteristics, method success rate, respiratory, and adverse outcomes. A multi-professional team developed a standardized LISA approach and a training program including an educational film, checklists, pocket cards, and team briefings. Twenty-one preterm infants received LISA before and 24 after the intervention. The mean LISA success rate improved from 62% before the intervention to 92% (p = 0.029) after the intervention. Implementing a highly standardized LISA approach and multi-professional team training significantly improved the methods’ success rate.

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Effectiveness and safety profile of introducing less invasive surfactant administration in management of respiratory distress syndrome: A retrospective cohort study in a tertiary neonatal unit in Hong Kong

Bao,

Feng,

Liu

et al. 2024

Pediatrics & Neonatology

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Minimally invasive surfactant therapy versus intubation for surfactant delivery in preterm infant with RDS: evaluation of safety and efficacy

Cited by 5 publications

References 15 publications

Comparison of mortality and short-term outcomes between classic, intubation-surfactant-extubation, and less invasive surfactant administration methods of surfactant replacement therapy

Comparison of mortality and short-term outcomes between classic, intubation-surfactant-extubation, and less invasive surfactant administration methods of surfactant replacement therapy

Improved Less Invasive Surfactant Administration Success in Preterm Infants after Procedure Standardization

Effectiveness and safety profile of introducing less invasive surfactant administration in management of respiratory distress syndrome: A retrospective cohort study in a tertiary neonatal unit in Hong Kong

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