Catheter and Laryngeal Mask Endotracheal Surfactant Therapy: the CALMEST approach as a novel MIST technique

Abstract

This novel procedure is quick, effective and well tolerated and might represent an improvement in reducing neonatal stress. Ultimately, CALMEST offers an alternative approach that could be extremely useful for medical staff with low expertise in laryngoscopy and intubation.

Rigid catheters reduced duration of less invasive surfactant therapy procedures in manikins

“…One was an interesting device that used a soft catheter that was advanced through a rigid, curved applicator . For larger infants, laryngoscopy could be avoided by inserting the tracheal catheter through a laryngeal mask . In the same population, direct instillation of surfactant through a laryngeal mask was also found effective in clinical studies .…”

<p>Bronchopulmonary Dysplasia: An Overview</p>

“…88,89 With the known benefits of surfactant administration in the reduction of respiratory distress syndrome, and BPD, new approaches to its administration, less invasive surfactant administration (LISA) and minimally invasive surfactant therapy (MIST), are gaining clinical interest worldwide, and in some regions considered standard of care. 87,90,91 Kribs et al first described LISA, a method for delivering surfactant to infants on CPAP in 2007 with placement of a catheter through the vocal cords under direct laryngoscopy. 90,91 While this approach does not require intubation with an endotracheal tube, it does require laryngoscopy.…”

Surfactant for Respiratory Distress Syndrome: New Ideas on a Familiar Drug with Innovative Applications

“…Recently, a study (CALMEST) was published which combined use of an LMA as a guide for a LISA catheter to administer surfactant [58]. Also, Poets and colleagues [59] developed a special soft catheter to administer surfactant less invasively without Magill forceps.…”