European perspective on less invasive surfactant administration-a survey.

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 use...

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Publicado en:European Journal of Pediatrics Vol. 176; no. 2; pp. 147 - 155
Autores principales: Klotz, Daniel, Porcaro, Ugo, Fleck, Thilo, Fuchs, Hans
Formato: Journal Article
Publicado: Springer Nature Feb2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2017
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00431-016-2812-9
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        atl: European perspective on less invasive surfactant administration-a survey.
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        au:
          Klotz, Daniel
          Porcaro, Ugo
          Fleck, Thilo
          Fuchs, Hans
        affil: Department of Woman, Child and General and Specialized Surgery , Second University of Naples , Naples Italy
      sug:
        subj:
          Intubation, Intratracheal Methods
          Intensive Care, Neonatal Methods
          Pulmonary Surfactants Administration and Dosage
          Neonatology Statistics and Numerical Data
          Europe
          Infant, Premature
          Respiratory Distress Syndrome, Newborn
          Pulmonary Surfactants Adverse Effects
          Premedication
          Intensive Care, Neonatal Statistics and Numerical Data
          Gestational Age
          Infant, Newborn
          Intubation, Intratracheal Statistics and Numerical Data
          Bradycardia Epidemiology
          Personal Resource Questionnaire
          Questionnaires
          Scales
          Infant, Newborn: birth-1 month
      ab: 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.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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