International Survey Showed That Supraglottic Airway Devices Were Not Often Used for Surfactant Administration

Surfactant can be administered by an endotracheal tube or by a catheter through the vocal cords, but both techniques need laryngoscopy skills and can be associated with complications. Supraglottic airway devices have also been used for surfactant administration, and we conducted an international survey to understand how much this is done in current practice.

This online survey was conducted from September 2023 to June 2024. Questions broadly addressed unit structure, practices around surfactant, and the role of supraglottic airway device in their unit.

There were a total of 75 responses, 73% from the United Kingdom. Most of the responses were from intensive care (55%). Fifty-three units reported the use of a supraglottic airway device only in cases of unsuccessful intubation. Only 12 units report the use of a supraglottic airway device for surfactant administration. Twenty-two units reported that they are likely to use this device in the near future, and five of the special care units reported that this technique would be useful for units with limited intubation skills.

There is limited uptake of using supraglottic airway device for surfactant administration. Lack of training, guidelines, and evidence are the most common reasons limiting this practice.