Surfactant Administration through Laryngeal Mask Airway: A Randomized Controlled Study in Rabbits

Bernardo, Cristian A.; Mariani, Gonzalo; Virasoro, María de los Ángeles; Burgos, Sebastián; Labanca, M.; Otero, Pablo E.

doi:10.1055/s-0037-1608931

Cited by 5 publications

(1 citation statement)

References 43 publications

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“…No differences in oxygenation or lung histopathology were found between the two groups. 45 Whether this aspect of administration is truly clinically important requires further evaluation.…”

Section: Respiratory Support During Proceduresmentioning

confidence: 99%

Supraglottic airway devices for administration of surfactant to newborn infants with respiratory distress syndrome: a narrative review

Roberts

Manley

O’Shea

et al. 2020

Arch Dis Child Fetal Neonatal Ed

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Surfactant is an effective treatment for respiratory distress syndrome, being particularly important for infants in whom continuous positive airway pressure (CPAP) provides insufficient support. Supraglottic airway devices present an attractive option for surfactant delivery, particularly as an alternative to methods dependent on direct laryngoscopy, a procedural skill that is both difficult to learn and in which to maintain competence. Published studies provide encouraging data that surfactant administration by supraglottic airway device can be performed with a high rate of success and may reduce the need for subsequent intubation compared with either continued CPAP or surfactant administration via endotracheal tube. However, existing randomised controlled trials (RCTs) are heterogeneous in design and include just over 350 infants in total. To date, all RCT evidence has been generated in tertiary units, whereas the greatest potential for benefit from the use of these devices is likely to be in non-tertiary settings. Future research should investigate choice and utility of device in addition to safety and effectiveness of procedure. Importantly, studies conducted in non-tertiary settings should evaluate feasibility, meaningful clinical outcomes and the impact that this approach might have on infants and their families. Supraglottic airway devices may represent a simple and effective mode of surfactant administration that can be widely used by a variety of clinicians. However, further well-designed RCTs are required to determine their role, safety and effectiveness in both tertiary and non-tertiary settings before introduction into routine clinical practice.

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“…No differences in oxygenation or lung histopathology were found between the two groups. 45 Whether this aspect of administration is truly clinically important requires further evaluation.…”

Section: Respiratory Support During Proceduresmentioning

confidence: 99%

Supraglottic airway devices for administration of surfactant to newborn infants with respiratory distress syndrome: a narrative review

Roberts

Manley

O’Shea

et al. 2020

Arch Dis Child Fetal Neonatal Ed

View full text Add to dashboard Cite

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Randomized Trial of Surfactant Therapy via Laryngeal Mask Airway Versus Brief Tracheal Intubation in Neonates Born Preterm

Gallup

Ndakor

Pezzano

et al. 2023

The Journal of Pediatrics

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Surfactant Administration Through Laryngeal or Supraglottic Airways

2021

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Noninvasive ventilation is frequently used in the treatment of infants with respiratory distress syndrome. This practice is often effective in higher gestational age neonates, but can be difficult in those with lower gestational ages as surfactant deficiency can be severe. While noninvasive ventilation avoids the negative effects of intubation and ventilator-induced lung injury, failure of this mode of support does occur with relative frequency and is primarily caused by the poorly compliant, surfactant-deficient lung. Because of the potential problems associated with laryngoscopy and intubation, neonatologists have developed various methods to deliver surfactant in minimally invasive ways with the aim of improving the success of noninvasive ventilation. Methods of minimally invasive surfactant administration include various thin catheter techniques, aerosolization/nebulization, and the use of a laryngeal mask airway/supraglottic airway device. The clinician should recognize that currently the only US Food and Drug Administration–approved device to deliver surfactant is an endotracheal tube and all methods reviewed here are considered off-label use. This review will focus primarily on surfactant administration through laryngeal or supraglottic airways, providing a review of the history of this technique, animal and human trials, and comparison with other minimally invasive techniques. In addition, this review provides a step-by-step instruction guide on how to perform this procedure, including a multimedia tutorial to facilitate learning.

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Surfactant Administration through Laryngeal Mask Airway: A Randomized Controlled Study in Rabbits

Abstract: In this animal model, surfactant administration through a preinserted feeding tube within the LMA lumen is safe and effective while providing the benefits of a minimally invasive approach. This technique reduces the need of PPV and may prevent its potential risks.

Cited by 5 publications

References 43 publications

Supraglottic airway devices for administration of surfactant to newborn infants with respiratory distress syndrome: a narrative review

Supraglottic airway devices for administration of surfactant to newborn infants with respiratory distress syndrome: a narrative review

Randomized Trial of Surfactant Therapy via Laryngeal Mask Airway Versus Brief Tracheal Intubation in Neonates Born Preterm

Surfactant Administration Through Laryngeal or Supraglottic Airways

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