MISA (Minimally Invasive Surfactant Administration) Versus Insure (Intubation, Surfactant, Extubation) In Preterms Less Than 34 Weeks With RDS

Garib, Mohamed I.; Fotoh, Wafaa Moustafa M. Abo El; Ramadan, Mohamad A.

doi:10.21608/ejhm.2021.201984

Cited by 3 publications

(1 citation statement)

References 13 publications

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“…Neurodevelopmental outcomes were reported in two studies [ 53 , 54 ]. Five studies used the stiff vascular catheter [ 31 , 36 , 38 , 39 , 48 ] and twenty studies used a feeding tube with or without forceps [ 27 – 30 , 32 , 34 , 35 , 37 , 40 – 47 , 49 – 52 ]; one study did not specify the technique of administration [ 33 ]. Two studies compared STC to intubation for surfactant with MV [ 32 , 34 ], two studies used nCPAP as a control group [ 27 , 48 ], while the remaining 22 studies used INSURE as their control group.…”

Section: Resultsmentioning

confidence: 99%

Surfactant delivery via thin catheter in preterm infants: A systematic review and meta-analysis

et al. 2023

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Objective Surfactant administration via a thin catheter (STC) is an alternative to surfactant administration post endotracheal intubation in preterm infants with respiratory distress syndrome (RDS); however, the benefits particularly in infants <29 weeks’ gestation and the neurodevelopmental outcomes remain unclear. Thus, our objective was to systematically review and meta-analyze the efficacy and safety of STC compared to intubation for surfactant or nasal continuous positive airway pressure (nCPAP) in preterm infants with RDS. Methods Medical databases were searched until December 2022 for randomized controlled trials (RCTs) assessing STC compared to controls that included intubation for surfactant or nCPAP in preterm infants with RDS. The primary outcome was bronchopulmonary dysplasia (BPD) at 36 weeks gestation in survivors. Subgroup analysis was conducted comparing STC to controls in infants < 29 weeks’ gestation. The Cochrane risk of bias (ROB) tool was used and certainty of evidence (CoE) was rated according to GRADE. Results Twenty-six RCTs of 3349 preterm infants, in which half of the studies had low risk of bias, were included. STC decreased the risk of BPD in survivors compared to controls (17 RCTs; N = 2408; relative risk (RR) = 0.66; 95% confidence interval (CI) 0.51 to 0.85; number needed to treat for an additional beneficial outcome (NNTB) = 13; CoE: moderate). In infants < 29 weeks’ gestation, STC significantly reduced the risk of BPD compared to controls (6 RCTs, N = 980; RR 0.63; 95% CI 0.47 to 0.85; NNTB = 8; CoE: moderate). Conclusions Compared to controls, STC may be a more efficacious and safe method of surfactant delivery in preterm infants with RDS, including infants < 29 weeks’ gestation.

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Section: Resultsmentioning

confidence: 99%

Surfactant delivery via thin catheter in preterm infants: A systematic review and meta-analysis

et al. 2023

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A Single Center Experience of Less Invasive Surfactant Administration during 6-Year

Bae

Shim

2022

Perinatology

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Comparing the Effects of Two Surfactant Administration Methods: Minimally Invasive Surfactant Therapy (MIST) with Intubation (INSURE) in Infants with Respiratory Distress Syndrome

Boskabadi,

Behmadi,

Maamouri

et al. 2024

ARM

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Background: The aim of this study is to investigate and compare the effects of administering a surfactant through a fine intra-tracheal catheter during spontaneous breathing with the usual INSURE method in premature infants. Materials and Methods: In this clinical trial, premature babies with respiratory distress syndrome who required surfactant administration were randomly assigned to two groups: an intervention group (MIST) and a control group (INSURE). The treatment results were compared in terms of complications related to treatment (desaturation, apnea, bradycardia, and surfactant reflux), respiratory complications (requirement for mechanical ventilation, duration of nCPAP, duration of oxygen requirement, frequency of pneumothorax, and pulmonary hemorrhage), complications related to prematurity (incidence of IVH, NEC, BPD, and PDA), the need for a second dose of surfactant, and the duration of hospitalization. Results: a total of 160 premature babies with a gestational age of 26–34 weeks were randomly divided into two groups. The results showed that the need for mechanical ventilation, the duration of CPAP needed, and the duration of oxygen therapy were significantly lower in the MIST group than in the INSURE group. Additionally, the incidence of BPD was less common in the MIST group compared to the INSURE group. However, surfactant reflux was more common in the MIST group than in the INSURE group. There were no significant differences between the two groups in other outcomes, including the length of hospital stay and complications such as IVH, PDA, NEC, pneumothorax, and pulmonary hemorrhage. Conclusion: The results of this research demonstrate that the less invasive method of surfactant therapy (MIST) is a feasible, effective, and low-risk alternative to the INSURE method.

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MISA (Minimally Invasive Surfactant Administration) Versus Insure (Intubation, Surfactant, Extubation) In Preterms Less Than 34 Weeks With RDS

Cited by 3 publications

References 13 publications

Surfactant delivery via thin catheter in preterm infants: A systematic review and meta-analysis

Surfactant delivery via thin catheter in preterm infants: A systematic review and meta-analysis

A Single Center Experience of Less Invasive Surfactant Administration during 6-Year

Comparing the Effects of Two Surfactant Administration Methods: Minimally Invasive Surfactant Therapy (MIST) with Intubation (INSURE) in Infants with Respiratory Distress Syndrome

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