TY - JOUR
T1 - Alternative Methods of Surfactant Administration in Preterm Infants with Respiratory Distress Syndrome
T2 - State of the Art
AU - Erdeve, Ömer
AU - Okulu, Emel
AU - Roberts, Kari D.
AU - Guthrie, Scott O.
AU - Fort, Prem
AU - Kutman, H. Gözde Kanmaz
AU - Dargaville, Peter A.
N1 - Publisher Copyright:
© 2021, AVES. All rights reserved.
PY - 2021
Y1 - 2021
N2 - For preterm infants with respiratory distress syndrome, delivery of surfactant via brief intubation (INtubate, SURfactant, Extubate; InSurE) has been the standard technique of surfactant administration. However, this method requires intubation and positive pressure ventilation. It is thought that even the short exposure to positive pressure inflations may be enough to initiate the cascade of events that lead to lung injury in the smallest neonates. In an effort to avoid tracheal intubation and positive pressure ventilation, several alternative and less invasive techniques of exogenous surfactant administration have been developed over the years. These have been investigated in clinical studies, including randomized clinical trials, and have demonstrated advantages such as a decrease in the need for mechanical ventilation and incidence of bronchopulmonary dysplasia. These newer techniques of surfactant delivery also have the benefit of being easier to perform. Surfactant delivery via pharyngeal instillation, laryngeal mask, aerosolization, and placement of a thin catheter are being actively pursued in research. We present a contemporary review of surfactant administration for respiratory distress syndrome via these alternative methods in the hope of guiding physicians in their choices for surfactant application in the neonatal intensive care unit.
AB - For preterm infants with respiratory distress syndrome, delivery of surfactant via brief intubation (INtubate, SURfactant, Extubate; InSurE) has been the standard technique of surfactant administration. However, this method requires intubation and positive pressure ventilation. It is thought that even the short exposure to positive pressure inflations may be enough to initiate the cascade of events that lead to lung injury in the smallest neonates. In an effort to avoid tracheal intubation and positive pressure ventilation, several alternative and less invasive techniques of exogenous surfactant administration have been developed over the years. These have been investigated in clinical studies, including randomized clinical trials, and have demonstrated advantages such as a decrease in the need for mechanical ventilation and incidence of bronchopulmonary dysplasia. These newer techniques of surfactant delivery also have the benefit of being easier to perform. Surfactant delivery via pharyngeal instillation, laryngeal mask, aerosolization, and placement of a thin catheter are being actively pursued in research. We present a contemporary review of surfactant administration for respiratory distress syndrome via these alternative methods in the hope of guiding physicians in their choices for surfactant application in the neonatal intensive care unit.
KW - Aerosol
KW - Laryngeal mask
KW - Less invasive surfactant administration
KW - Nebulized
KW - Pharyngeal instillation
KW - Preterm
KW - Respiratory distress syndrome
KW - Surfactant
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UR - http://www.scopus.com/inward/citedby.url?scp=85122940476&partnerID=8YFLogxK
U2 - 10.5152/TurkArchPediatr.2021.21240
DO - 10.5152/TurkArchPediatr.2021.21240
M3 - Review article
C2 - 35110053
AN - SCOPUS:85122940476
SN - 1306-0015
VL - 56
SP - 553
EP - 562
JO - Turkish Archives of Pediatrics
JF - Turkish Archives of Pediatrics
IS - 6
ER -