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Early Experience With Less Invasive Surfactant Administration Under Heated Humidified High-Flow Nasal Cannula in
Melek Büyükeren1, Tolga Celik2, Sule Yigit2
1Konya City Hospital, Department of Pediatrics, Division of Neonatology, Turkey, Konya.
Zeitschrift Fur Geburtshilfe Und Neonatologie
|July 22, 2026
Summary
Less invasive surfactant administration (LISA) is feasible with heated humidified high-flow nasal cannula (HHHFNC) support in preterm infants. Short-term physiological monitoring showed no significant differences compared to nasal continuous positive airway pressure (CPAP).
Area of Science:
- Neonatal Medicine
- Pediatric Respiratory Care
- Intensive Care
Background:
- Less invasive surfactant administration (LISA) is a common procedure for preterm infants with respiratory distress syndrome.
- Nasal continuous positive airway pressure (CPAP) is the standard support for LISA.
- Limited evidence exists for LISA performed under heated humidified high-flow nasal cannula (HHHFNC) support.
Purpose of the Study:
- To assess the feasibility of performing LISA under ongoing HHHFNC support.
- To compare short-term physiological parameters in preterm infants undergoing LISA with HHHFNC versus CPAP.
Main Methods:
- An observational pilot study in a tertiary neonatal intensive care unit.
- Inclusion of preterm infants requiring surfactant therapy within 72 hours of life.
- Monitoring of vital signs, blood gas parameters, perfusion index (PI), and pleth variability index (PVI) in infants receiving either HHHFNC or CPAP support.
Main Results:
- 34 preterm infants were analyzed (22 on CPAP, 12 on HHHFNC).
- No significant differences were found in vital signs, blood gases, PI, or PVI between the groups.
- Higher oxygen saturation was observed in the HHHFNC group at 360 minutes post-administration.
Conclusions:
- LISA can be technically performed under HHHFNC in selected preterm infants.
- No major short-term physiological instability was noted during monitoring.
- Further research is needed due to the observational design and small sample size to draw conclusions on comparative safety or efficacy.
