Peter Reynolds1, Porus Bustani2, Colm Darby3, Jose Ramon Fernandez Alvarez4, Grenville Fox5, Steve Jones6, Sara Jane Robertson1, Vimal Vasu7, Charles Christoph Roehr8,9. 1. Neonatal Intensive Care Unit, St. Peter's Hospital, Ashford & St. Peter's Hospitals NHS Foundation Trust, Chertsey, United Kingdom. 2. Children's and Adolescent Services, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom. 3. Neonatal Unit, Craigavon Area Hospital, Portadown, United Kingdom. 4. Department of Neonatology, Brighton and Sussex University Hospitals NHS Trust, Brighton, United Kingdom. 5. Evelina London Children's Hospital Neonatal Unit, Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom. 6. Neonatology, Royal United Hospital, Bath, United Kingdom. 7. Neonatal Medicine, East Kent Hospitals University NHS Foundation Trust, William Harvey Hospital, Ashford, United Kingdom. 8. National Perinatal Epidemiology Unit, Medical Sciences Division, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom. 9. Newborn Services, John Radcliffe Hospital, Oxford University Hospitals, NHS Foundation Trust, Oxford, United Kingdom.
Abstract
INTRODUCTION: Less-invasive surfactant administration (LISA) is a method of surfactant delivery to preterm infants for treating respiratory distress syndrome (RDS), which can reduce the composite risk of death or bronchopulmonary dysplasia and the time on mechanical ventilation. METHODS: A systematic literature search of studies published up to April 2021 on minimally invasive catheter surfactant delivery in preterm infants with RDS was conducted. Based on these studies, with parental feedback sought via an online questionnaire, 9 UK-based specialists in neonatal respiratory disease developed their consensus for implementing LISA. Recommendations were developed following a modified, iterative Delphi process using a questionnaire employing a 9-point Likert scale and an a priori level of agreement/disagreement. RESULTS: Successful implementation of LISA can be achieved by training the multidisciplinary team and following locally agreed guidance. From the time of the decision to administer surfactant, LISA should take <30 min. The comfort of the baby and requirements to maintain non-invasive respiratory support are important. While many infants can be managed without requiring additional sedation/analgesia, fentanyl along with atropine may be considered. Parents should be provided with sufficient information about medication side effects and involved in treatment discussions. CONCLUSION: LISA has the potential to improve outcomes for preterm infants with RDS and can be introduced as a safe and effective part of UK-based neonatal care with appropriate training.
INTRODUCTION: Less-invasive surfactant administration (LISA) is a method of surfactant delivery to preterm infants for treating respiratory distress syndrome (RDS), which can reduce the composite risk of death or bronchopulmonary dysplasia and the time on mechanical ventilation. METHODS: A systematic literature search of studies published up to April 2021 on minimally invasive catheter surfactant delivery in preterm infants with RDS was conducted. Based on these studies, with parental feedback sought via an online questionnaire, 9 UK-based specialists in neonatal respiratory disease developed their consensus for implementing LISA. Recommendations were developed following a modified, iterative Delphi process using a questionnaire employing a 9-point Likert scale and an a priori level of agreement/disagreement. RESULTS: Successful implementation of LISA can be achieved by training the multidisciplinary team and following locally agreed guidance. From the time of the decision to administer surfactant, LISA should take <30 min. The comfort of the baby and requirements to maintain non-invasive respiratory support are important. While many infants can be managed without requiring additional sedation/analgesia, fentanyl along with atropine may be considered. Parents should be provided with sufficient information about medication side effects and involved in treatment discussions. CONCLUSION: LISA has the potential to improve outcomes for preterm infants with RDS and can be introduced as a safe and effective part of UK-based neonatal care with appropriate training.
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: Christoph Härtel; Egbert Herting; Alexander Humberg; Kathrin Hanke; Katrin Mehler; Titus Keller; Isabell Mauer; Eric Frieauff; Sascha Meyer; Ulrich H Thome; Christian Wieg; Susanne Schmidtke; Angela Kribs; Wolfgang Göpel Journal: JAMA Netw Open Date: 2022-08-01