scholarly journals Improved Less Invasive Surfactant Administration Success in Preterm Infants after Procedure Standardization

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1145
Author(s):  
Björn Liebers ◽  
Chinedu Ulrich Ebenebe ◽  
Monika Wolf ◽  
Martin Ernst Blohm ◽  
Eik Vettorazzi ◽  
...  
Keyword(s):  
Success Rate ◽  
Preterm Infants ◽  
Patient Characteristics ◽  
Team Training ◽  
Adverse Outcomes ◽  
Less Invasive ◽  
Characteristics Method ◽  
Perinatal Center ◽  
The Mean ◽  
Surfactant Administration

Less invasive surfactant administration (LISA) has been introduced at our tertiary Level IV perinatal center since 2016 with an unsatisfactory success rate, which we attributed to an inconsistent, non-standardized approach and ambiguous patient inclusion criteria. This study aimed to improve the LISA success rate to at least 75% within 12 months by implementing a highly standardized LISA approach combined with team training. The Plan Do Study Act method of quality improvement was used for this initiative. Baseline assessment included a review of patient medical records 12 months before the intervention regarding patient characteristics, method success rate, respiratory, and adverse outcomes. A multi-professional team developed a standardized LISA approach and a training program including an educational film, checklists, pocket cards, and team briefings. Twenty-one preterm infants received LISA before and 24 after the intervention. The mean LISA success rate improved from 62% before the intervention to 92% (p = 0.029) after the intervention. Implementing a highly standardized LISA approach and multi-professional team training significantly improved the methods’ success rate.

The effect of less invasive surfactant administration on cerebral oxygenation in preterm infants

2019 ◽  
Vol 109 (2) ◽  
pp. 291-299 ◽  
Author(s):  
Kathrin Hanke ◽  
Tanja K. Rausch ◽  
Pia Paul ◽  
Isabel Hellwig ◽  
Christina Krämer ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Cerebral Oxygenation ◽  
Less Invasive ◽  
Surfactant Administration

scholarly journals Safety and Efficacy of Early High Parenteral Lipid Supplementation in Preterm Infants: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1535
Author(s):  
Kyunghoon Kim ◽  
Na Jin Kim ◽  
Sae Yun Kim
Keyword(s):  
Systematic Review ◽  
Preterm Infants ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Early Initiation ◽  
High Dose ◽  
Equivalent Age ◽  
High Lipid ◽  
The Mean ◽  
Extrauterine Growth Restriction

The objective of this systematic review and meta-analysis was to summarize the effects of early initiation and achievement of a high dose of parenteral lipids (≥1.5 g/kg/day reached within the first 24 h of birth) on growth and adverse outcomes in preterm infants. PubMed, EMBASE, and Cochrane databases were utilized to search for publications for this meta-analysis. Randomized controlled trials were eligible if data on growth or clinical outcome was available. The search returned nine studies. The mean proportion of postnatal weight loss (%) was lower (mean difference [MD]: −2.73; 95% confidence interval [CI]: −3.69, −1.78), and the mean head circumference near the term equivalent age (cm) was higher in the early high lipid treatment group (MD: 0.67; 95% CI: 0.25, 1.09). There was a favorable association of early high lipid administration with the incidence of extrauterine growth restriction (relative risk [RR]: 0.27; 95% CI: 0.15, 0.48). Generally, there were no differences in morbidities or adverse outcomes with early high lipid administration. Early initiation of parenteral lipids and high dose achieved within the first 24 h of life appear to be safe and endurable and offer benefits in terms of growth.

Propofol for sedation during less invasive surfactant administration in preterm infants

2017 ◽  
Vol 102 (5) ◽  
pp. F465-F465 ◽  
Author(s):  
Claire Sophie Descamps ◽  
Marie Chevallier ◽  
Anne Ego ◽  
Isabelle Pin ◽  
Chloé Epiard ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Less Invasive ◽  
Surfactant Administration

scholarly journals Colonoscopy in patients without sedation: an experience from Nepal

1970 ◽  
Vol 10 (1) ◽  
pp. 27-29 ◽  
Author(s):  
B Pradhan ◽  
N Pandey
Keyword(s):  
Success Rate ◽  
Indirect Costs ◽  
Patient Characteristics ◽  
Intravenous Sedation ◽  
Painful Procedure ◽  
Cecal Intubation ◽  
Resource Poor ◽  
Inflammatory Bowel ◽  
The Mean ◽  
Irritable Bowel

Background: Colonoscopy is considered a painful procedure requiring routine intravenous sedation, however there are number of potential advantages to performing colonoscopy without sedation. Objective: To determine the effect of unsedated colonoscopy on the success rate of caecal intubation. Methods: All charts of patients who had unsedated colonoscopy from September 2010 to August 2011 were reviewed. Patient characteristics including age, gender, and mode of presentation were collected. The reasons for incomplete colonoscopy and sites reached were recorded. Results: During the study period, 127 examinations were performed without sedation. The mean age of the patients was 41.9 years with 79% males. The most common indication for performing colonoscopy was irritable bowel syndrome and the predominant endoscopic finding was colitis other than inflammatory bowel disease. The completion rate was 80.3%. Conclusion: In this study, sedation probably affects the overall success rate of cecal intubation. But unsedated colonoscopy can be used in resource poor settings to minimize direct and indirect costs of colonoscopy. DOI: http://dx.doi.org/10.3126/hren.v10i1.6003 HREN 2012; 10(1): 27-29

scholarly journals Less-Invasive Surfactant Administration for Neonatal Respiratory Distress Syndrome: A Consensus Guideline

Neonatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Peter Reynolds ◽  
Porus Bustani ◽  
Colm Darby ◽  
Jose Ramon Fernandez Alvarez ◽  
Grenville Fox ◽  
...  
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Preterm Infants ◽  
Distress Syndrome ◽  
Successful Implementation ◽  
Sufficient Information ◽  
Online Questionnaire ◽  
Less Invasive ◽  
Risk Of Death ◽  
Surfactant Administration

<b><i>Introduction:</i></b> Less-invasive surfactant administration (LISA) is a method of surfactant delivery to preterm infants for treating respiratory distress syndrome (RDS), which can reduce the composite risk of death or bronchopulmonary dysplasia and the time on mechanical ventilation. <b><i>Methods:</i></b> A systematic literature search of studies published up to April 2021 on minimally invasive catheter surfactant delivery in preterm infants with RDS was conducted. Based on these studies, with parental feedback sought via an online questionnaire, 9 UK-based specialists in neonatal respiratory disease developed their consensus for implementing LISA. Recommendations were developed following a modified, iterative Delphi process using a questionnaire employing a 9-point Likert scale and an a priori level of agreement/disagreement. <b><i>Results:</i></b> Successful implementation of LISA can be achieved by training the multidisciplinary team and following locally agreed guidance. From the time of the decision to administer surfactant, LISA should take &#x3c;30 min. The comfort of the baby and requirements to maintain non-invasive respiratory support are important. While many infants can be managed without requiring additional sedation/analgesia, fentanyl along with atropine may be considered. Parents should be provided with sufficient information about medication side effects and involved in treatment discussions. <b><i>Conclusion:</i></b> LISA has the potential to improve outcomes for preterm infants with RDS and can be introduced as a safe and effective part of UK-based neonatal care with appropriate training.

Sign in / Sign up

Export Citation Format

Share Document