Minimally or less invasive surfactant replacement therapy in neonates: A narrative review

2022 ◽  
Vol 11 (1) ◽  
pp. 45
Author(s):  
Gengaimuthu Karthikeyan
Author(s):  
T. Queliz Pena ◽  
J.A. Perez ◽  
M.J. Corrigan

BACKGROUND: Less invasive surfactant replacement therapy (SRT) methods have been linked to better respiratory outcomes. The primary aim of this study was to determine if Less Invasive Surfactant Administration (LISA) altered the rate of bronchopulmonary dysplasia (BPD) in preterm infants. Secondary objectives were to determine if LISA compared to Intubation Surfactant Extubation (InSurE) resulted in different respiratory outcomes and hospital course. METHODS: In this retrospective chart review, outcomes were compared in two preterm infant groups (25–32 weeks gestation). Infants in Group 1 received surfactant replacement therapy (SRT) via InSurE method, while infants in Group 2 received SRT via LISA method. RESULTS: Regardless of SRT method utilized, there were no significant differences in rates of BPD between the two groups in infants born at 25–32 weeks gestation (30.6% vs 33.3% ; P = 0.47). CONCLUSIONS: Despite using LISA method rather than InSurE for SRT, premature infants continue to be at high risk for BPD. LISA shows promise as a safe, noninvasive SRT alternative to invasive methods like InSurE.


2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Robert Qaqish ◽  
Yui Watanabe ◽  
Marcos Galasso ◽  
Cara Summers ◽  
A adil Ali ◽  
...  

Abstract Background There are limited therapeutic options directed at the underlying pathological processes in acute respiratory distress syndrome (ARDS). Experimental therapeutic strategies have targeted the protective systems that become deranged in ARDS such as surfactant. Although results of surfactant replacement therapy (SRT) in ARDS have been mixed, questions remain incompletely answered regarding timing and dosing strategies of surfactant. Furthermore, there are only few truly clinically relevant ARDS models in the literature. The primary aim of our study was to create a clinically relevant, reproducible model of severe ARDS requiring extracorporeal membrane oxygenation (ECMO). Secondly, we sought to use this model as a platform to evaluate a bronchoscopic intervention that involved saline lavage and SRT. Methods Yorkshire pigs were tracheostomized and cannulated for veno-venous ECMO support, then subsequently given lung injury using gastric juice via bronchoscopy. Animals were randomized post-injury to either receive bronchoscopic saline lavage combined with SRT and recruitment maneuvers (treatment, n = 5) or recruitment maneuvers alone (control, n = 5) during ECMO. Results PaO2/FiO2 after aspiration injury was 62.6 ± 8 mmHg and 60.9 ± 9.6 mmHg in the control and treatment group, respectively (p = 0.95) satisfying criteria for severe ARDS. ECMO reversed the severe hypoxemia. After treatment with saline lavage and SRT during ECMO, lung physiologic and hemodynamic parameters were not significantly different between treatment and controls. Conclusions A clinically relevant severe ARDS pig model requiring ECMO was established. Bronchoscopic saline lavage and SRT during ECMO did not provide a significant physiologic benefit compared to controls.


Neonatology ◽  
1992 ◽  
Vol 61 (1) ◽  
pp. 54-58 ◽  
Author(s):  
Richard J. Tubman ◽  
Simon J. Rankin ◽  
Henry L. Halliday ◽  
Stewart S. Johnston

Neonatology ◽  
2011 ◽  
Vol 100 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Anton H. van Kaam ◽  
Anne P. De Jaegere ◽  
Dorine Borensztajn ◽  
Peter C. Rimensberger

Neonatology ◽  
2006 ◽  
Vol 89 (4) ◽  
pp. 282-283 ◽  
Author(s):  
Ola Didrik Saugstad ◽  
Tore Curstedt ◽  
Henry L. Halliday ◽  
Bengt Robertson ◽  
Christian P. Speer

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