Novel Surfactant Administration Techniques: Will They Change Outcome?

Barkhuff, Whittney; Soll, Roger F.

doi:10.1159/000497328

Cited by 32 publications

(42 citation statements)

References 26 publications

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“…A more recent meta-analysis attempted to control for study heterogeneity by performing two analyses: one strictly comparing LISA and INSURE, and another comparing LISA to standard intubation and subsequent IMV. LISA was not found to be superior for decreasing BPD or the combined outcome of BPD or death (59). Of note, all RCTs evaluated are small, with only ∼450 preterm infants included across all studies.…”

Section: Minimally Invasive Surfactant Therapymentioning

confidence: 92%

“…LISA procedure was first described in the early 1990s and was rediscovered about 10 years later (51,58). It has been widely used in Germany and increasing parts of Europe meanwhile, and is the most intensively studied method of less invasive surfactant therapy (49,53,54,59). The first RCT of the German Neonatal Network including 220 preterm infants born at 26-28 weeks' gestation demonstrated a reduced need of IMV at any time and reduced median days on IMV in the LISA cohort (60).…”

Section: Minimally Invasive Surfactant Therapymentioning

confidence: 99%

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Fine Tuning Non-invasive Respiratory Support to Prevent Lung Injury in the Extremely Premature Infant

2020

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Within the last decades, therapeutic advances, such as antenatal corticosteroids, surfactant replacement, monitored administration of supplemental oxygen, and sophisticated ventilatory support have significantly improved the survival of extremely premature infants. In contrast, the incidence of some neonatal morbidities has not declined. Rates of bronchopulmonary dysplasia (BPD) remain high and have prompted neonatologists to seek effective strategies of non-invasive respiratory support in high risk infants in order to avoid harmful effects associated with invasive mechanical ventilation. There has been a stepwise replacement of invasive mechanical ventilation by early continuous positive airway pressure (CPAP) as the preferred strategy for initial stabilization and for early respiratory support of the premature infant and management of respiratory distress syndrome. However, the vast majority of high risk babies are mechanically ventilated at least once during their NICU stay. Adjunctive therapies aiming at the prevention of CPAP failure and the support of functional residual capacity have been introduced into clinical practice, including alternative techniques of administering surfactant as well as non-invasive ventilation approaches. In contrast, the strategy of applying sustained lung inflations in the delivery room has recently been abandoned due to evidence of higher rates of death within the first 48 h of life.

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Section: Minimally Invasive Surfactant Therapymentioning

confidence: 92%

Section: Minimally Invasive Surfactant Therapymentioning

confidence: 99%

Fine Tuning Non-invasive Respiratory Support to Prevent Lung Injury in the Extremely Premature Infant

2020

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“…58 Therefore, to minimize exposure to endotracheal intubation and the negative aspects of mechanical ventilation, several methods of less invasive surfactant replacement have been developed. 59…”

Section: Surfactant Replacement Therapymentioning

confidence: 99%

“…Of these methods, TCA via feeding tube, flexible angiocatheter, or specialty introducer tubes has been most extensively investigated. 59 The TCA procedure requires direct or video-assisted laryngoscopy, followed by the insertion of a catheter into the trachea and through the vocal cords of spontaneously breathing infants. 63 Although methods vary slightly, surfactant can be delivered while the infant continues to receive noninvasive support.…”

Section: Novel Delivery Approachesmentioning

confidence: 99%

2019 Year in Review: Neonatal Respiratory Support

Wheeler

Smallwood

2020

Respir Care

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Respiratory support of the critically ill neonate has steadily shifted from invasive to noninvasive forms of support. There have recently been a number of important advances in our understanding of the changes to neonatal resuscitation practices as they pertain to clinically important outcomes, mechanisms of gas exchange for high-flow nasal cannula, and best use of noninvasive ventilation and predicting response. Although the proportion of infants requiring intubation and mechanical ventilation has decreased, the most severely ill often still require intubation and ventilation. Recently, volume-targeted ventilation, high-frequency ventilation, and different methods of assessing weaning and extubation have been investigated. This review summarizes a number of important advances that have been made in the management of prematurity and neonatal respiratory distress syndrome.

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“…11 Out of these, thin catheter was found to be an effective method as it reduced the need for mechanical ventilation especially during 1 st 72 hours of life. 12,13,14 Pakistan stands 4 th amongst countries with highest rate of preterm births. 15 Consequential increase in the incidence of RDS is demanding of specialized NICUs and proper guidelines for surfactant administration.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of surfactant administration to preterm infants via thin catheter versus InSurE technique.

Riaz

Asmat²,

Shaukat

et al. 2020

TPMJ

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Objectives: To compare the efficacy of administering surfactant to preterm infants using thin catheter and Intubate-Surfactant-Extubate (InSurE) techniques in terms of need of mechanical ventilation within 1st 72 hours of life. Study Design: Randomized controlled trial. Setting: Neonatal intensive care unit (NICU), Federal Postgraduate Medical Institute and Shaikh Zayed Hospital (FPGMI and SZH), Lahore. Period: From November 2014 to April 2015. Material & Methods: A total of one hundred preterm infants who developed respiratory distress syndrome (RDS) and fulfilled the inclusion criteria were enrolled in the study. The enrolled infants were randomly divided into two groups each comprising fifty infants. The infants in Group A were administered surfactant via thin catheter technique, whereas those in Group B by InSurE technique. The infants were monitored by clinical and laboratory parameters for the need of mechanical ventilation within 1st 72 hours of life. Descriptive statistical analyses were performed. Results: Majority of the preterm infants in Group A (54%) and Group B (56%) were born through Caesarean section. Group A constituted 58% (n=29) males and 42% (n=21) female infants, while Group B constituted 52% (n=26) males and 48% (n=24) females. Mean gestational age in Group A and Group B was found to be 29.43±4.24 weeks and 28.54±3.87 weeks, respectively. Mean birth weight in Group A and Group B was found to be 1375.87+143.36 and 1392.87+129.27 grams, respectively. Efficacy of surfactant was recorded as 64% (n=32) in group A and 44% (n=22) in group B (p=0.04). Conclusion: Surfactant administration using thin catheter is significantly more efficacious than InSurE in respect of the need of mechanical ventilation during 1st 72 hours of life.

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Novel Surfactant Administration Techniques: Will They Change Outcome?

Cited by 32 publications

References 26 publications

Fine Tuning Non-invasive Respiratory Support to Prevent Lung Injury in the Extremely Premature Infant

Fine Tuning Non-invasive Respiratory Support to Prevent Lung Injury in the Extremely Premature Infant

2019 Year in Review: Neonatal Respiratory Support

Efficacy of surfactant administration to preterm infants via thin catheter versus InSurE technique.

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