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Related Concept Videos

Cardiopulmonary Resuscitation V: Advanced Airway Management Techniques01:30

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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Endoscopic Studies I: Bronchoscopy and Thoracoscopy01:30

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Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
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Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
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Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
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Suctioning the Oropharyngeal Airway01:25

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Tracheostomy suctioning is a critical procedure healthcare professionals perform to maintain a patent airway in patients with a tracheostomy tube. This procedure is necessary when secretions accumulate in the airway, causing respiratory distress. Here is a step-wise procedural guide for performing tracheostomy suctioning using an open system.
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Related Experiment Video

Updated: Jan 8, 2026

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Low invasive surfactant administration by videolaringoscopy: a feasibility study.

Flavia Petrillo1, Camilla Gizzi2, Luigia Valenzano1

  • 1NICU "Di Venere" Hospital, Via Ospedale di Venere, 1, Bari, 70131, Italy.

Italian Journal of Pediatrics
|December 22, 2025
PubMed
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The FRI&NDLI procedure, using videolaryngoscopy for less invasive surfactant administration (LISA), is safe for preterm infants. This method showed fewer adverse effects compared to traditional LISA, supporting further research.

Keywords:
LISAPreterm infantRDSSurfactantVideolaryngoscopy

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Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Medical Devices

Background:

  • Less invasive surfactant administration (LISA) is an emerging, gentle technique for surfactant delivery in noninvasively ventilated infants.
  • This method may offer benefits for very preterm infants requiring respiratory support.
  • The FRee of Invasiveness & Neonatal Delicate LISA (FRI&NDLI) study investigated a novel approach to LISA.

Purpose of the Study:

  • To evaluate the feasibility and safety of using videolaryngoscopy for precise catheter placement in LISA.
  • To assess the effectiveness of the FRI&NDLI procedure in administering surfactant to preterm infants.

Main Methods:

  • A prospective study involving preterm infants (24+0-32+6 weeks gestation) between September 2020 and January 2024.
  • Data collected on infants with mild/moderate respiratory distress syndrome (RDS) undergoing the FRI&NDLI procedure.
  • Recorded frequency of successful procedures and incidence of related adverse effects.

Main Results:

  • Twenty-three infants (28.9 ± 2.8 weeks gestation) underwent 25 FRI&NDLI procedures.
  • Videolaryngoscopy for glottis visualization had no associated apnoea, bradycardia, or desaturation.
  • Surfactant administration resulted in 2 bradycardia episodes, 8 desaturations, and 1 surfactant reflux.

Conclusions:

  • The FRI&NDLI procedure demonstrated safety and fewer adverse effects than direct laryngoscopy-assisted LISA.
  • Findings suggest the FRI&NDLI method is a viable alternative for surfactant delivery.
  • Further studies are warranted to compare the efficacy of FRI&NDLI versus traditional LISA in preterm infants.