Alternative routes of surfactant application - An update

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology

Background:

• Non-invasive respiratory support is the primary choice for preterm infants with respiratory distress syndrome (RDS).
• Avoiding invasive mechanical ventilation reduces morbidity and mortality in preterm infants.
• Some infants require surfactant administration despite initial non-invasive support, and failure of non-invasive support is linked to adverse outcomes.

Purpose of the Study:

• To explore methods for combining non-invasive respiratory support with surfactant therapy in preterm infants.
• To review and discuss the evidence, limitations, and future research directions for less invasive surfactant administration techniques.

Main Methods:

• Review of clinical studies on less or minimally invasive surfactant therapy methods.
• Description of various surfactant application techniques.
• Discussion of existing evidence and limitations.

Main Results:

• Several less or minimally invasive surfactant therapy methods have been developed.
• Evidence from clinical studies is reported, with discussion of limitations for each method.

Conclusions:

• Combining non-invasive respiratory support with surfactant therapy is crucial for managing symptomatic RDS in preterm infants.
• Further research is needed to optimize less invasive surfactant administration techniques and improve clinical outcomes.