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Article
High-volume surfactant administration using a minimally invasive technique: Experience from a Canadian Neonatal Intensive Care Unit.
Paediatrics & Child Health
  • Soume Bhattacharya, Western University
  • Brooke Read, London Helath Sciences Centre
  • Evelyn McGovern, London Health Sciences Centre
  • Orlando da Silva, Western University
Document Type
Article
Publication Date
8-1-2019
URL with Digital Object Identifier
https://doi.org/10.1093/pch/pxy162
Disciplines
Abstract

Background:
Surfactant delivery via a thin endotracheal catheter during spontaneous breathing, a technique called minimally invasive surfactant therapy (MIST), is an alternative to intubation and surfactant administration. There is paucity of data regarding the administration of high-volume surfactant using this technique.

Methods:
We conducted a retrospective cohort study to review the safety, efficacy, and procedural details pertaining to the delivery of 5 mL/kg of BLES® via MIST approach. In 2016, our centre initiated a practice change allowing the use of MIST as an alternative method of surfactant delivery in infants born at ≥28 weeks and/or with a birth weight ≥ 1,000 g with respiratory distress syndrome. In this study, we identified all neonates who received surfactant via MIST between May 1, 2016 and July 30, 2018 and collected relevant procedural data.

Results:
Since this practice change, MIST technique was attempted in 43 neonates with successful instillation of surfactant in 41 (95.3%) of the neonates. Intubation and positive pressure ventilation was avoided in 35 neonates (85.3%). No serious adverse effect was noted.

Conclusions:
Our study reports successful use of higher volume surfactant via MIST. This should encourage other similar centres to consider this technique, in order to avoid unnecessary intubation and positive pressure ventilation.

Citation Information
Soume Bhattacharya, Brooke Read, Evelyn McGovern and Orlando da Silva. "High-volume surfactant administration using a minimally invasive technique: Experience from a Canadian Neonatal Intensive Care Unit." Paediatrics & Child Health Vol. 24 Iss. 5 (2019) p. 313 - 317
Available at: http://works.bepress.com/soume-bhattacharya/1/