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Factors Associated with Intubation After Less Invasive Surfactant Administration (LISA); A Single-Center Cohort from
Kamal Ali1,2,3, Abdulghani Lodhi1, Saleh S Alqarni1,2,3
1Neonatal Intensive Care Department, King Abdulaziz Medical City-Riyadh, Ministry of National Guard Health Affairs, P.O. Box 22490, Riyadh 11426, Saudi Arabia.
Children (Basel, Switzerland)
|September 27, 2025
Summary
Less invasive surfactant administration (LISA) is feasible in Middle Eastern NICUs, but failure is linked to prematurity and increases risks. Careful patient selection is key to optimizing outcomes for preterm infants receiving LISA.
Area of Science:
- Neonatal Medicine
- Pediatric Respiratory Care
- Critical Care
Background:
- Less invasive surfactant administration (LISA) aims to reduce mechanical ventilation in preterm infants.
- Factors influencing LISA failure in routine practice, especially outside Europe, require further investigation.
Purpose of the Study:
- To identify factors associated with LISA failure in a Middle Eastern NICU.
- To determine the impact of LISA failure on neonatal outcomes, including intraventricular hemorrhage (IVH) and NICU length of stay.
Main Methods:
- A single-center retrospective cohort study included preterm infants (26-34 weeks gestation) receiving LISA.
- LISA failure was defined as intubation within 72 hours for specific respiratory complications.
- Multivariable logistic regression and Kaplan-Meier methods were used to analyze predictors of failure and outcomes.
Main Results:
- LISA failure occurred in 39% of the 41 infants studied.
- Lower gestational age was the sole independent predictor of LISA failure (aOR 1.44).
- LISA failure was independently associated with higher rates of IVH (aOR 10.08) and prolonged NICU stay.
Conclusions:
- LISA is a feasible surfactant therapy in a high-acuity Middle Eastern NICU.
- Lower gestational age is a significant risk factor for LISA failure, which is linked to adverse outcomes like IVH and extended hospitalization.
- Optimizing LISA outcomes necessitates careful patient selection and meticulous procedural planning.
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