A Comparative Study of the Effectiveness of Surfactant Administration by a Less Invasive Surfactant Administration...

Area of Science:

• Neonatal respiratory care
• Pulmonology
• Pediatric critical care

Background:

• Conventional surfactant administration via tracheal tube poses a risk of lung injury due to positive pressure ventilation.
• Less invasive surfactant administration (LISA) offers a potential alternative to reduce ventilator-induced lung injury in neonates.

Purpose of the Study:

• To evaluate the feasibility and benefits of LISA compared to the intubation-surfactant-extubation (INSURE) method.
• To compare respiratory support duration and surfactant administration outcomes between LISA and INSURE groups.

Main Methods:

• A randomized clinical trial involving 120 neonates with respiratory distress syndrome (RDS) was conducted between 2021 and 2023.
• Infants were randomized into two groups: INSURE (n=60) receiving surfactant via tracheal tube, and LISA (n=60) receiving surfactant via nasal continuous positive airway pressure (CPAP) using a thin catheter.
• Key outcomes included duration of respiratory support and primary/secondary outcomes during surfactant injection.

Main Results:

• The duration of respiratory support via nasal CPAP (nCPAP) and high-flow nasal cannula was significantly longer in the LISA group (P=0.00).
• No statistically significant differences were observed in primary and secondary outcomes between the LISA and INSURE groups during surfactant injection.

Conclusions:

• This study found no significant difference in primary or secondary outcomes between the LISA and INSURE methods for surfactant administration.
• The increased duration of respiratory support in the LISA group warrants further investigation.
• Additional research is necessary to fully elucidate the comparative efficacy and safety of LISA and INSURE.