Less invasive surfactant administration for meconium aspiration syndrome

Area of Science:

• Neonatal Medicine
• Pediatric Pulmonology
• Critical Care

Background:

• The management of meconium aspiration syndrome (MAS) remains a clinical challenge.
• The efficacy of less invasive surfactant administration (LISA) via a thin catheter in MAS is not well-established.

Purpose of the Study:

• To compare the outcomes of surfactant administration using mechanical ventilation (MV) versus LISA in infants with MAS.
• To evaluate the impact of LISA on respiratory support needs and hospital length of stay.

Main Methods:

• Retrospective study of infants with MAS between January 2016 and December 2023.
• Comparison of outcomes between endotracheal tube surfactant (ETT-surf) and LISA groups.
• Exclusion of infants intubated at birth.

Main Results:

• The LISA group showed a significantly lower need for MV (23% vs 100%, p<0.001) and inhaled nitric oxide (iNO) (12% vs 46%, p=0.01) compared to the ETT-surf group.
• Infants receiving LISA had a shorter median hospital stay (14 vs 24 days, p=0.04).
• Subgroup analysis confirmed reduced MV need and hospital stay in the LISA group for infants with hypoxic respiratory failure.

Conclusions:

• LISA is associated with reduced need for mechanical ventilation and inhaled nitric oxide.
• LISA may lead to a shorter hospital duration for select infants with MAS.
• Further prospective research is warranted to confirm the role of LISA in MAS management.