Surfactant delivery via thin catheters: Methods, limitations, and outcomes

Devi, Usha; Pandita, Aakash

doi:10.1002/ppul.25599

Cited by 10 publications

(10 citation statements)

References 82 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Lastly, among all the less invasive surfactant methods, the one using the thin catheter is most studied and practised. However, we agree that data for neonates <28 weeks are not as robust as for higher gestation age group due to a smaller number of neonates,4 5 and we need more data for this vulnerable population. In addition, lung recruitment before surfactant administration (IN-REC-SUR-E) represents a promising novel alternative6; hence, future randomized evidence directly comparing it to less invasive surfactant administration with thin catheters is warranted to draw conclusions concerning the optimal method of surfactant treatment, especially among extremely low gestational age newborns.…”

mentioning

confidence: 71%

SurE for surfactant: response to letter

Bellos

Pandita

2021

Arch Dis Child Fetal Neonatal Ed

Self Cite

View full text Add to dashboard Cite

mentioning

confidence: 71%

SurE for surfactant: response to letter

Bellos

Pandita

2021

Arch Dis Child Fetal Neonatal Ed

Self Cite

View full text Add to dashboard Cite

“…Further studies may focus on two issues. One was which population could take most advantage from the method of LISA, although it had been proven to be safe for neonates with a gestational age < 26 weeks [ 27 ]. The other was providing/incorporating the follow-up data of the survivors, who received LISA methods.…”

Section: Discussionmentioning

confidence: 99%

Effects of less invasive surfactant administration versus intubation-surfactant-extubation on bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome: a single-center, retrospective study from China

Bao

Zhao

et al. 2022

BMC Pulm Med

View full text Add to dashboard Cite

Background This study evaluated the effects of less invasive surfactant administration (LISA) and intubation-surfactant-extubation (InSurE) on bronchopulmonary dysplasia (BPD) in preterm infants with respiratory distress syndrome (RDS). Methods Neonates with respiratory distress syndrome requiring surfactant, with gestational age < 32 weeks and birth weight < 1500 g admitted to our neonatal intensive care unit from January 2018 to December 2019, were retrospectively analyzed. LISA and InSurE were used independently. The incidence of BPD at 36 weeks postmenstrual age, pre-discharge mortality, and need for mechanical ventilation (MV) within 72 h of birth were compared between LISA and InSurE group. Secondary outcomes including necrotizing enterocolitis requiring surgery, retinopathy of prematurity ≥ stage 3, patent ductus arteriosus requiring medical therapy or surgery, and length of hospitalization were analyzed. Results Among the 148 included neonates, there were 46 and 102 infants in LISA group and InSurE group, respectively. There were no significant differences in BPD incidence, the severity of BPD at 36 weeks postmenstrual age, and the rate of MV within the first 72 h after birth between the two groups (P > 0.05, respectively). The incidences of necrotizing enterocolitis requiring surgery, retinopathy of prematurity ≥ stage 3, patent ductus arteriosus requiring medical therapy or surgery, and length of hospitalization did not differ significantly between the two groups (P > 0.05, respectively). Conclusions For surfactant administration among preterm infants with respiratory distress syndrome, LISA did not decrease bronchopulmonary dysplasia and severity of BPD at 36 weeks postmenstrual age. The benefits of LISA would require further evaluations.

show abstract

“…However, it is necessary to emphasize differences in the target populations for tracheal tubes and thin catheters. While the thin catheter is primarily used in neonates with spontaneous breathing and stable hemodynamics ( 36 ), the advantages of the new dual-lumen catheter focus on neonates receiving mechanical ventilation, although still suitable for neonates requiring tracheal intubation in other situations. It is this difference that establishes the unassailable position of surfactant administration via the tracheal tube.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of a novel double-lumen tracheal tube in neonates with RDS: A prospective cohort study

Du²,

Yang³

et al. 2022

Front. Pediatr.

View full text Add to dashboard Cite

BackgroundThe purpose of this study was to assess the safety and efficacy of a new double-lumen tracheal tube for neonates, with a conventional tracheal tube as a control.MethodNewborns with respiratory distress syndrome (RDS) requiring endotracheal intubation admitted to the tertiary neonatal intensive care unit (NICU) of Qujing Maternal and Child Healthcare Hospital in Yunnan Province between March 2021 and May 2022 were enrolled in this prospective cohort study. Outcome indicators related to effectiveness included mainly the number of intubations, duration of ventilation, duration of oxygenation, and length of stay; safety indicators included any clinical adverse effects during and after intubation. Appropriate stratified and subgroup analyses were performed according to the purpose of intubation, gestational age, and whether the drug was administered via endotracheal tube.ResultA total of 101 neonates were included and divided into two groups based on the choice of tracheal tube: the conventional (n = 50) and new (n = 51) tracheal tube groups. There was no statistical difference between the two groups in terms of adverse effects during and after intubation (p > 0.05). In neonates who were mechanically ventilated without endotracheal surfactant therapy or newborns receiving InSurE technique followed by non-invasive ventilation, no significant differences were found between the two groups regarding any of the efficacy indicators (p > 0.05). However, for neonates on invasive mechanical ventilation, the new tracheal tube allowed for a significant reduction in the duration of mechanical ventilation (96.50[74.00, 144.00] vs. 121.00[96.00, 196.50] hours, p = 0.037) and total ventilation (205.71 ± 80.24 vs. 277.56 ± 117.84 h, p = 0.027), when used as a route for endotracheal drug delivery. Further analysis was performed according to gestational age for newborns requiring intratracheal surfactant administration during mechanical ventilation, and the data showed that for preterm infants, the new tracheal tube not only shortened the duration of mechanical ventilation (101.75 ± 39.72 vs. 155.50 ± 51.49 h, p = 0.026) and total ventilation (216.00 ± 81.60 vs. 351.50 ± 113.79 h, p = 0.010), but also demonstrated significant advantages in reducing the duration of oxygen therapy (9.75 ± 6.02 vs. 17.33 ± 8.43 days, p = 0.042); however, there was no statistical difference in efficacy outcomes between the two groups in full-term infants (p > 0.05).ConclusionThe efficacy and safety of this new tracheal tube are promising in neonates with RDS, especially those requiring surfactant administration via a tracheal tube during mechanical ventilation. Given the limitations of this study, however, the clinical feasibility of this catheter needs to be further confirmed in prospective randomized trials with larger sample sizes.Clinical Trial Registrationhttp://www.chictr.org.cn/showproj.aspx?proj=122073

show abstract

Surfactant delivery via thin catheters: Methods, limitations, and outcomes

Cited by 10 publications

References 82 publications

SurE for surfactant: response to letter

SurE for surfactant: response to letter

Effects of less invasive surfactant administration versus intubation-surfactant-extubation on bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome: a single-center, retrospective study from China

Safety and efficacy of a novel double-lumen tracheal tube in neonates with RDS: A prospective cohort study

Contact Info

Product

Resources

About