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Updated: Sep 16, 2025

A Minimally Invasive Method for Intratracheal Instillation of Drugs in Neonatal Rodents to Treat Lung Disease
Published on: August 4, 2021
Less invasive surfactant administration in the delivery room: A quality improvement initiative
Jonathan R Burris1, Blair F Germain2, Patricia R Chess2
1Department of Pediatrics, Division of Neonatology, University of Rochester Medical Center, 601 Elmwood Avenue, Box 651, Rochester, NY, 14642, USA. jonathan_burris@urmc.rochester.edu.
Objective:
To evaluate less invasive surfactant administration (LISA) in the delivery room as a part of neonatal stabilization and reduce infants requiring intubation.
Project Design:
A SMART aim was developed to implement LISA in >30% of infants (25.0-31.6 weeks' gestational age) with respiratory distress syndrome (RDS) in the NICU or delivery room (DR) and increase the number of infants never requiring intubation by 50% by 12/31/2023. Three sequential Plan-Do-Study-Act cycles were implemented. Statistical Process Control charts tracked time-ordered data.
Results:
Over 4 years, 184 patients received LISA (N = 112 in the DR). LISA was safe and successful (98.9%), including DR. DR intubations were reduced (65.5 to 52.6%), infants never requiring intubation increased (22.8 to 38%), and Grade 2 or 3 BPD (12.9 to 8.8%) was reduced.
Conclusion:
LISA in the delivery room is safe and effective for RDS and associated with reduced need for intubation, mechanical ventilation, and BPD.
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