Randomized Trial of Surfactant Therapy via Laryngeal Mask Airway vs. Brief Tracheal Intubation

Gallup, Jacqueline A.; Pinheiro, Joaquim; Ndakor, Sussan Mbi; Pezzano, Chad

doi:10.1542/peds.147.3_meetingabstract.755

Cited by 5 publications

(9 citation statements)

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“…Of the eight RCTs, five studies compared LMA SRT with the INSURE technique 15,17,19,20,22 and two compared LMA SRT with CPAP alone (without surfactant administration). 16,18 One study compared LMA SRT with the tradition method of surfactant administration through an ETT followed by mechanical ventilation 21 (as opposed to INSURE which strives for rapid extubation).…”

Section: Short-term Outcomesmentioning

confidence: 99%

“…A systematic review and meta-analysis by Al Ali 26 consisting of six RCTs (analysis performed before publication of two RCTs 15,20 ) found that LMA SRT decreased the need for intubation and mechanical ventilation compared with CPAP alone and surfactant via an endotracheal tube. Number of surfactant doses was higher in the LMA SRT group compared to the control group.…”

Section: Short-term Outcomesmentioning

confidence: 99%

“…The lower limit for enrollment in majority of studies was 1000-1250 g since the size of currently available LMAs limits its use in extremely low birth weight babies (< 1 kg). However, studies have enrolled infants down to 800 g (smallest enrolled infant weighing 880 g 14 and 810 g. 15 2.1 | Procedure Among the eight RCTs, seven used an LMA with an inflatable cuff [15][16][17][18][19][20][21] and one used a noninflatable cuff 22 (Table 1). The LMA was placed following package insert instructions using Brains technique.…”

Section: Lmamentioning

confidence: 99%

“…16,18 One study compared LMA SRT with the tradition method of surfactant administration through an ETT followed by mechanical ventilation 21 (as opposed to INSURE which strives for rapid extubation). Primary outcome for six studies [15][16][17][18]20,22 was need for mechanical ventilation. Primary outcome for two studies was reduction in oxygen requirement.…”

Section: Short-term Outcomesmentioning

confidence: 99%

“…The lower limit for enrollment in majority of studies was 1000–1250 g since the size of currently available LMAs limits its use in extremely low birth weight babies (< 1 kg). However, studies have enrolled infants down to 800 g (smallest enrolled infant weighing 880 g 14 and 810 g 15 …”

Section: Lmamentioning

confidence: 99%

See 4 more Smart Citations

A systematic review of surfactant delivery via laryngeal mask airway, pharyngeal instillation, and aerosolization: Methods, limitations, and outcomes

Devi

Roberts

Pandita

2021

Pediatric Pulmonology

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Less invasive surfactant administration methods without laryngoscopy and endotracheal catheterization include delivery via laryngeal mask airway, pharyngeal instillation, and aerosolization. These less invasive techniques are promising and have several advantages over INSURE (Intubation-Surfactant-Extubation) and thin catheter techniques. The objective of this review is to discuss the requisites, techniques, short-term outcomes, and adverse events associated with these methods.

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Section: Short-term Outcomesmentioning

confidence: 99%

Section: Short-term Outcomesmentioning

confidence: 99%

Section: Lmamentioning

confidence: 99%

Section: Short-term Outcomesmentioning

confidence: 99%

Section: Lmamentioning

confidence: 99%

See 3 more Smart Citations

A systematic review of surfactant delivery via laryngeal mask airway, pharyngeal instillation, and aerosolization: Methods, limitations, and outcomes

Devi

Roberts

Pandita

2021

Pediatric Pulmonology

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Respiratory Severity Score and Oxygen Saturation Index during the First 2 Hours of Life as Predictors for Noninvasive Respiratory Support Failure in Respiratory Distress Syndrome

Zapata,

Koueik,

Becker

et al. 2024

Am J Perinatol

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Background: Noninvasive respiratory support (NRS) failure is common in preterm infants with respiratory distress syndrome (RDS). We evaluated the utility of Respiratory Severity Score (RSS) and Oxygen Saturation Index (OSI) during the first two hours of life (HOL) as a predictor for NRS failure in moderate preterm infants. Methods: We conducted a retrospective cohort study of infants born between 28 0/7 to 33 6/7 weeks with RDS. Univariate and multivariable logistic regression analysis were used to assess whether the RSS and OSI summary measures were associated with NRS failure. Results: A total of 282 infants were included in the study. Median GA and birthweights were 32 weeks and 1.7 Kg respectively. Fifty eight infants (21%) developed NRS failure at median age of 10.5 hours. RSS and OSI summary measures in the first 2 HOL were associated with NRS failure within 72 HOL. Conclusion: RSS and OSI during the first two HOL can predict NRS failure. Optimal RSS and OSI cutoffs for prediction of NRS failure need to be determined in large cohort studies.

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Laryngeal Mask Airway Clinical Use and Training: A Survey of North American Neonatal Health Care Professionals

et al. 2023

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Objective The aim of this study was to explore North American neonatal health care professionals' (HCPs) experience, confidence, skill, and training with the laryngeal mask airway (LMA). Study Design This was a cross-sectional survey. Results The survey was completed by 2,159 HCPs from Canada and the United States. Seventy nine percent had no clinical experience with the LMA, and less than 20% considered the LMA an alternative to endotracheal intubation (EI). The majority had received LMA training; however, 28% of registered nurses, 18% of respiratory therapists, 17% of physicians, and 12% of midwives had never inserted an LMA in a mannequin. Less than a quarter of respondents agreed that the current biennial Neonatal Resuscitation Program instruction paradigm is sufficient for LMA training. All groups reported low confidence and skill with LMA insertion, and compared with all other groups, the respiratory therapists had the highest reported confidence and skill. Conclusion This survey study, which is the first of its kind to include midwives, demonstrates that neonatal HCPs lack experience, confidence, skill, and training with the LMA, rarely use the device, and in general, do not consider the LMA as an alternative to EI. These findings contribute to, and support the findings of previous smaller studies, and in conjunction with the diminishing opportunities for EI, highlight the need for programs to emphasize the importance of the LMA for neonatal airway management and prioritize regular LMA training, with focus that parallels the importance placed on the skills of EI and mask ventilation. Key Points

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Randomized Trial of Surfactant Therapy via Laryngeal Mask Airway vs. Brief Tracheal Intubation

Cited by 5 publications

References 0 publications

A systematic review of surfactant delivery via laryngeal mask airway, pharyngeal instillation, and aerosolization: Methods, limitations, and outcomes

A systematic review of surfactant delivery via laryngeal mask airway, pharyngeal instillation, and aerosolization: Methods, limitations, and outcomes

Respiratory Severity Score and Oxygen Saturation Index during the First 2 Hours of Life as Predictors for Noninvasive Respiratory Support Failure in Respiratory Distress Syndrome

Laryngeal Mask Airway Clinical Use and Training: A Survey of North American Neonatal Health Care Professionals

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