Daniel Klotz1,2, Ugo Porcaro3, Thilo Fleck4,5, Hans Fuchs6,5. 1. Center for Pediatrics, Department of Neonatology, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany. daniel.klotz@uniklinik-freiburg.de. 2. Faculty of Medicine, University of Freiburg, Freiburg, Germany. daniel.klotz@uniklinik-freiburg.de. 3. Department of Woman, Child and General and Specialized Surgery, Second University of Naples, Naples, Italy. 4. Center for Pediatrics, Department of Pediatric Cardiology, Heart Center - University of Freiburg, Freiburg, Germany. 5. Faculty of Medicine, University of Freiburg, Freiburg, Germany. 6. Center for Pediatrics, Department of Neonatology, Medical Center - University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
Abstract
Less invasive surfactant administration or minimally invasive surfactant therapy (LISA/MIST) has been proposed for the administration of surfactant in preterm infants without intubation. The aim of our survey was to assess the rate of utilization, premedication as well as technique and equipment used for LISA/MIST. Furthermore, attitudes and experiences in regard to indications, side effects, and efficacy should be assessed. An online-based survey was sent to 324 neonatologists from different centers within 37 European countries between December 2015 and March 2016. Of those 165 who responded (response rate 51%), 86 (52%) were using LISA/MIST. It is regarded the standard procedure for surfactant administration by 41%, with a wide variation in personal views on patient selection in terms of indication, appropriate gestational and postnatal age. Policies concerning premedication, devices, and technique of LISA/MIST differed widely. Side effects like surfactant reflux, bradycardia, and hypoxia were observed by 77% of neonatologists. Of neonatologists inexperienced in LISA/MIST, 89% would consider utilizing it in the future. Perceived efficacy of LISA/MIST was high (52%) to medium (33%). CONCLUSION: The use of LISA/MIST within Europe is widespread. There is a wide variation concerning all aspects of LISA in daily clinical routine and different views on when and how LISA should be performed. What is Known: • Noninvasive surfactant administration has been the subject of randomized controlled trials and has found its way into clinical routine. What is New: • Noninvasive surfactant administration techniques are widely applied in European neonatal units. • There is a wide variety of equipment used and techniques applied for less invasive surfactant delivery as well as different views on the indications and perceived efficacy of this intervention.
Less invasive surfactant administration or minimally invasive surfactant therapy (LISA/MIST) has been proposed for the administration of surfactant in preterm infants without intubation. The aim of our survey was to assess the rate of utilization, premedication as well as technique and equipment used for LISA/MIST. Furthermore, attitudes and experiences in regard to indications, side effects, and efficacy should be assessed. An online-based survey was sent to 324 neonatologists from different centers within 37 European countries between December 2015 and March 2016. Of those 165 who responded (response rate 51%), 86 (52%) were using LISA/MIST. It is regarded the standard procedure for surfactant administration by 41%, with a wide variation in personal views on patient selection in terms of indication, appropriate gestational and postnatal age. Policies concerning premedication, devices, and technique of LISA/MIST differed widely. Side effects like surfactant reflux, bradycardia, and hypoxia were observed by 77% of neonatologists. Of neonatologists inexperienced in LISA/MIST, 89% would consider utilizing it in the future. Perceived efficacy of LISA/MIST was high (52%) to medium (33%). CONCLUSION: The use of LISA/MIST within Europe is widespread. There is a wide variation concerning all aspects of LISA in daily clinical routine and different views on when and how LISA should be performed. What is Known: • Noninvasive surfactant administration has been the subject of randomized controlled trials and has found its way into clinical routine. What is New: • Noninvasive surfactant administration techniques are widely applied in European neonatal units. • There is a wide variety of equipment used and techniques applied for less invasive surfactant delivery as well as different views on the indications and perceived efficacy of this intervention.
Authors: David G Sweet; Virgilio Carnielli; Gorm Greisen; Mikko Hallman; Eren Ozek; Richard Plavka; Ola Didrik Saugstad; Umberto Simeoni; Christian P Speer; Máximo Vento; Gerard H A Visser; Henry L Halliday Journal: Neonatology Date: 2016-09-21 Impact factor: 4.035
Authors: Angela Kribs; Claudia Roll; Wolfgang Göpel; Christian Wieg; Peter Groneck; Reinhard Laux; Norbert Teig; Thomas Hoehn; Wolfgang Böhm; Lars Welzing; Matthias Vochem; Marc Hoppenz; Christoph Bührer; Katrin Mehler; Hartmut Stützer; Jeremy Franklin; Andreas Stöhr; Egbert Herting; Bernhard Roth Journal: JAMA Pediatr Date: 2015-08 Impact factor: 16.193
Authors: Angela Kribs; C Härtel; E Kattner; M Vochem; H Küster; J Möller; D Müller; H Segerer; C Wieg; C Gebauer; W Nikischin; A v d Wense; E Herting; B Roth; W Göpel Journal: Klin Padiatr Date: 2010-01-18 Impact factor: 1.349
Authors: Laura Moschino; Viraraghavan Vadakkencherry Ramaswamy; Irwin Karl Marcel Reiss; Eugenio Baraldi; Charles Christoph Roehr; Sinno Henricus Paulus Simons Journal: Pediatr Res Date: 2022-06-02 Impact factor: 3.756
Authors: Janneke Dekker; Anton H van Kaam; Charles C Roehr; Andreas W Flemmer; Elizabeth E Foglia; Stuart B Hooper; Arjan B Te Pas Journal: Pediatr Res Date: 2019-06-19 Impact factor: 3.756
Authors: Mohamed E Abdel-Latif; Peter G Davis; Kevin I Wheeler; Antonio G De Paoli; Peter A Dargaville Journal: Cochrane Database Syst Rev Date: 2021-05-10
Authors: Laura Fabbri; Katrin Klebermass-Schrehof; Marta Aguar; Catherine Harrison; Ewa Gulczyńska; Debora Santoro; Marco Di Castri; Vincent Rigo Journal: Acta Paediatr Date: 2018-01-25 Impact factor: 2.299