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CC BY-NC-ND 4.0 · AJP Rep 2021; 11(03): e119-e122
DOI: 10.1055/s-0041-1735632
Original Article

Less Invasive Surfactant Administration in Very Prematurely Born Infants

Sandeep Shetty 
1   Neonatal Intensive Care Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
2   Department of Neonatal Medicine, St George's University of London, London, United Kingdom
,
Helen Egan
1   Neonatal Intensive Care Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
,
Peter Cornuaud
1   Neonatal Intensive Care Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
,
Anay Kulkarni 
1   Neonatal Intensive Care Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
2   Department of Neonatal Medicine, St George's University of London, London, United Kingdom
,
Donovan Duffy
1   Neonatal Intensive Care Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
2   Department of Neonatal Medicine, St George's University of London, London, United Kingdom
,
Anne Greenough 
3   Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
4   The Asthma UK Centre in Allergic Mechanisms of Asthma, Kings College London, London, United Kingdom
5   NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London, United Kingdom
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Abstract

Background Less invasive surfactant administration (LISA) is the preferred mode of surfactant administration for spontaneously breathing preterm babies supported by noninvasive ventilation (NIV).

Objective The aim of this study was to determine whether LISA on the neonatal unit or in the delivery suite was associated with reduced rates of bronchopulmonary dysplasia (BPD) or the need for intubation, or lower durations of invasive ventilation and length of hospital stay (LOS).

Methods A historical comparison was undertaken. Each “LISA” infant was matched with two infants (controls) who did not receive LISA.

Results The 25 LISA infants had similar gestational ages and birth weights to the 50 controls (28 [25.6–31.7] weeks vs. 28.5 [25.4–31.9] weeks, p = 0.732; 1,120 (580–1,810) g vs. 1,070 [540–1,869] g, p = 0.928), respectively. LISA infants had lower requirement for intubation (52 vs. 90%, p < 0.001), shorter duration of invasive ventilation (median 1 [0–35] days vs. 6 [0–62] days p = 0.001) and a lower incidence of BPD (36 vs. 64%, p = 0.022). There were no significant differences in duration of NIV (median 26 [3–225] vs. 23 [2–85] days, p = 0.831) or the total LOS (median 76 [24–259] vs. 85 [27–221], p = 0.238).

Conclusion LISA on the neonatal unit or the delivery suite was associated with a lower BPD incidence, need for intubation, and duration of invasive ventilation.

Keywords

less invasive surfactant administration - LISA - surfactant administration - BPD - duration of mechanical ventilation - length of hospital stay

Availability of Data and Materials

All data from this study are given in tables and as text in manuscript.


Authors' Contributions

Shetty and Greenough designed the study and approved the final manuscript as submitted. Shetty, Duffy, and Egan collected the data and approved the final manuscript as submitted. Cornuaud and Kulkarni designed the statistical analysis and analyzed the data and approved the final manuscript as submitted. All authors were involved in the preparation of the manuscript and approved the final manuscript as submitted.




Publication History

Received: 27 December 2020

Accepted: 04 March 2021

Article published online:
22 September 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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