TY - JOUR
T1 - Less Invasive Surfactant Administration in Preterm Infants in Tertiary Neonatal Intensive Care Units in Germany
T2 - A Survey
AU - LISA-Survey-Team Germany
AU - Maiwald, Christian A.
AU - Franz, Axel R.
AU - Poets, Christian F.
AU - Springer, Laila
AU - Trepels-Kottek, Sonja
AU - Wieg, Christian
AU - Völkl, Thomas M.K.
AU - Hammond, Edmondo N.L.
AU - Fischer, Hendrik S.
AU - Horsch, Sandra
AU - Belß, Madlen
AU - Weikert, Georg
AU - Weller, Ursula
AU - Schneider, Katja
AU - Holz, Sandra
AU - Semmler, Inga
AU - Dahlem, Peter
AU - Siemes, Anna
AU - Kribs, Angela
AU - Grunske, Albrecht
AU - Frey, Georg
AU - Hofmann, Michael
AU - Degirmenci, Metin
AU - Berghaeuser, Martin Andree
AU - Stein, Anja
AU - Meudt, Christopher
AU - Doberschütz, Nora
AU - Fuchs, Hans
AU - Dieks, Jana Katharina
AU - Schuler, Rahel
AU - Linnemann, Knud
AU - Haase, Roland
AU - Koch, Lutz
AU - Deindl, Philipp
AU - Guthmann, Florian
AU - Gille, Christian
AU - Proske, Manuel
AU - Bejo, Levente
AU - Wolf, Lina
AU - Longardt, Ann Carolin
AU - Jahn, Peter
AU - Schwade, Jan Niclas
AU - Celanowski, Catrice Mirka
AU - Böttger, Ralf
AU - Tippmann, Susanne
AU - Dittgen, Felix
AU - Hummler, Helmut
AU - Pallacks, Ralf
AU - Rößlein, Andreas
AU - Rieger-Fackeldey, Esther
N1 - Publisher Copyright:
© 2024 S. Karger AG, Basel.
PY - 2024
Y1 - 2024
N2 - Introduction: The European guideline for treatment of respiratory distress syndrome recommends less invasive surfactant administration (LISA) as the preferred method of surfactant administration in spontaneously breathing preterm infants. However, there is limited evidence on practical aspects such as sedation and catheter types, leading to considerable variability between centers. Methods: An anonymous online survey (www.soscisurvey.de) was sent to 164 tertiary neonatal intensive care units (NICUs) in Germany including 43 questions on practical aspects of LISA. Results: Of 122 (74%) participating NICUs, 117 (96%) reported experience with LISA with 82% of those reporting LISA as their preferred method of surfactant administration. Indications for surfactant administration differed widely between NICUs. Most (89%) used FiO2-thresholds only or in combination with other criteria, such as Silverman score/signs of dyspnea (41%) or lung ultrasound findings (3%). Prophylactic surfactant was administered by 42%. Differences in use of LISA in extremely immature infants were reported (e.g., 36% did not perform LISA in infants below 24–26 weeks). Preferred drugs for sedation were (Es-)Ketamine, followed by Propofol and Midazolam. Minimum time interval between subsequent LISA procedures was 4 (2–6) h. Catheters specifically designed for LISA were used by most NICUs (69%). Conclusion: This survey shows that LISA is common practice in German NICUs, but with considerable variability in practical aspects. These data may serve as a guidance for NICUs that have not yet implemented LISA and might be helpful design clinical trials with the aim to standardize and/or optimize LISA.
AB - Introduction: The European guideline for treatment of respiratory distress syndrome recommends less invasive surfactant administration (LISA) as the preferred method of surfactant administration in spontaneously breathing preterm infants. However, there is limited evidence on practical aspects such as sedation and catheter types, leading to considerable variability between centers. Methods: An anonymous online survey (www.soscisurvey.de) was sent to 164 tertiary neonatal intensive care units (NICUs) in Germany including 43 questions on practical aspects of LISA. Results: Of 122 (74%) participating NICUs, 117 (96%) reported experience with LISA with 82% of those reporting LISA as their preferred method of surfactant administration. Indications for surfactant administration differed widely between NICUs. Most (89%) used FiO2-thresholds only or in combination with other criteria, such as Silverman score/signs of dyspnea (41%) or lung ultrasound findings (3%). Prophylactic surfactant was administered by 42%. Differences in use of LISA in extremely immature infants were reported (e.g., 36% did not perform LISA in infants below 24–26 weeks). Preferred drugs for sedation were (Es-)Ketamine, followed by Propofol and Midazolam. Minimum time interval between subsequent LISA procedures was 4 (2–6) h. Catheters specifically designed for LISA were used by most NICUs (69%). Conclusion: This survey shows that LISA is common practice in German NICUs, but with considerable variability in practical aspects. These data may serve as a guidance for NICUs that have not yet implemented LISA and might be helpful design clinical trials with the aim to standardize and/or optimize LISA.
KW - Less-invasive surfactant administration
KW - Neonates
KW - Respiratory distress syndrome
UR - http://www.scopus.com/inward/record.url?scp=85199483337&partnerID=8YFLogxK
U2 - 10.1159/000539302
DO - 10.1159/000539302
M3 - Article
C2 - 39019018
AN - SCOPUS:85199483337
SN - 1661-7800
JO - Neonatology
JF - Neonatology
ER -