Less Invasive Surfactant Administration for Preterm Infants - State of the Art

Less invasive surfactant administration (LISA) has become the preferred method of surfactant administration for spontaneously breathing babies on continuous positive airway pressure (CPAP). The development of LISA followed the need to combine CPAP and surfactant replacement as mainstay treatment opt...

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Bibliographic Details
Published inNeonatology (Basel, Switzerland) Vol. 121; no. 5; p. 584
Main Authors Härtel, Christoph, Kribs, Angela, Göpel, Wolfgang, Dargaville, Peter, Herting, Egbert
Format Journal Article
LanguageEnglish
Published Switzerland 01.10.2024
Subjects
Less invasive surfactant administration
Surfactant
Continuous positive airway pressure
Outcome
Preterm infants
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Summary:Less invasive surfactant administration (LISA) has become the preferred method of surfactant administration for spontaneously breathing babies on continuous positive airway pressure (CPAP). The development of LISA followed the need to combine CPAP and surfactant replacement as mainstay treatment options for respiratory distress syndrome, thereby avoided exposure to positive pressure ventilation. This review summarises the current knowns and unknowns of LISA including the physiological concept, its relevance for short-term and long-term outcomes and the challenges for practical implementation of LISA as part of a less invasive respiratory care bundle. Further, we provide an update of the evidence on alternatives to LISA, for example, nebulised surfactant administration, pharyngeal deposition of surfactant and delivery via supraglottic airway.
ISSN:1661-7819
DOI:10.1159/000540078