Less invasive surfactant administration for meconium aspiration syndrome
Background The role of less invasive surfactant administration (LISA) using a thin catheter in the management of meconium aspiration syndrome (MAS) is unclear.Study design A retrospective study of infants with MAS admitted between January 2016 and December 2023. Relevant characteristics and outcomes...
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BMJ Publishing Group
2025-05-01
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| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/9/1/e003317.full |
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| author | DAVID B NELSON Arun Prasath Etze Chotzoglou Asmahan Ahmad Efren Diaz Patti Burchfield L. Steven Brown Katherine Stumpf Venkatakrishna Kakkilaya |
| author_facet | DAVID B NELSON Arun Prasath Etze Chotzoglou Asmahan Ahmad Efren Diaz Patti Burchfield L. Steven Brown Katherine Stumpf Venkatakrishna Kakkilaya |
| author_sort | DAVID B NELSON |
| collection | DOAJ |
| description | Background The role of less invasive surfactant administration (LISA) using a thin catheter in the management of meconium aspiration syndrome (MAS) is unclear.Study design A retrospective study of infants with MAS admitted between January 2016 and December 2023. Relevant characteristics and outcomes were compared between a group of infants receiving surfactant in conjunction with mechanical ventilation (MV) via an endotracheal tube (ETT-surf) and receiving LISA. Infants intubated at birth were excluded.Results Of the 113 infants admitted on continuous positive airway pressure (CPAP), 61 did not receive surfactant, 26 belonged to the ETT-surf group and 26 to the LISA group. Compared with the ETT-surf, a higher proportion of infants in the LISA group were exposed to chorioamnionitis and received a lower median fraction of inspired oxygen at birth and before surfactant therapy. Notably, infants in the LISA group had a lower need for MV (100 vs 23%, p<0.001), inhaled nitric oxide (iNO) (46% vs 12%, p=0.01) and a shorter median duration of hospital stay (14 vs 24 days, p=0.04). A subgroup analysis of infants with hypoxic respiratory failure on admission showed lower need for MV and duration of hospital stay with the LISA group compared with the ETT-surf group.Conclusions LISA was associated with a lower need for MV, iNO and a shorter duration of hospital stay in a select group of infants with MAS. Further prospective studies are necessary to evaluate the role of LISA in MAS. |
| format | Article |
| id | doaj-art-ecd2749eea344c1da67897c4576c423d |
| institution | DOAJ |
| issn | 2399-9772 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Paediatrics Open |
| spelling | doaj-art-ecd2749eea344c1da67897c4576c423d2025-08-20T02:57:28ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722025-05-019110.1136/bmjpo-2025-003317Less invasive surfactant administration for meconium aspiration syndromeDAVID B NELSON0Arun Prasath1Etze Chotzoglou2Asmahan Ahmad3Efren Diaz4Patti Burchfield5L. Steven Brown6Katherine Stumpf7Venkatakrishna Kakkilaya8UT Southwestern Medical Center, Dallas, Texas, USADivision of Neonatology, University of Texas Southwestern Medical Center, Dallas, USAColumbia University Medical Center, New York, New York, USAUT Southwestern Medical Center, Dallas, Texas, USAUT Southwestern Medical Center, Dallas, Texas, USAUT Southwestern Medical Center, Dallas, Texas, USADepartment of Pediatrics, Parkland Health and Hospital System, Dallas, Texas, USAUT Southwestern Medical Center, Dallas, Texas, USAUT Southwestern Medical Center, Dallas, Texas, USABackground The role of less invasive surfactant administration (LISA) using a thin catheter in the management of meconium aspiration syndrome (MAS) is unclear.Study design A retrospective study of infants with MAS admitted between January 2016 and December 2023. Relevant characteristics and outcomes were compared between a group of infants receiving surfactant in conjunction with mechanical ventilation (MV) via an endotracheal tube (ETT-surf) and receiving LISA. Infants intubated at birth were excluded.Results Of the 113 infants admitted on continuous positive airway pressure (CPAP), 61 did not receive surfactant, 26 belonged to the ETT-surf group and 26 to the LISA group. Compared with the ETT-surf, a higher proportion of infants in the LISA group were exposed to chorioamnionitis and received a lower median fraction of inspired oxygen at birth and before surfactant therapy. Notably, infants in the LISA group had a lower need for MV (100 vs 23%, p<0.001), inhaled nitric oxide (iNO) (46% vs 12%, p=0.01) and a shorter median duration of hospital stay (14 vs 24 days, p=0.04). A subgroup analysis of infants with hypoxic respiratory failure on admission showed lower need for MV and duration of hospital stay with the LISA group compared with the ETT-surf group.Conclusions LISA was associated with a lower need for MV, iNO and a shorter duration of hospital stay in a select group of infants with MAS. Further prospective studies are necessary to evaluate the role of LISA in MAS.https://bmjpaedsopen.bmj.com/content/9/1/e003317.full |
| spellingShingle | DAVID B NELSON Arun Prasath Etze Chotzoglou Asmahan Ahmad Efren Diaz Patti Burchfield L. Steven Brown Katherine Stumpf Venkatakrishna Kakkilaya Less invasive surfactant administration for meconium aspiration syndrome BMJ Paediatrics Open |
| title | Less invasive surfactant administration for meconium aspiration syndrome |
| title_full | Less invasive surfactant administration for meconium aspiration syndrome |
| title_fullStr | Less invasive surfactant administration for meconium aspiration syndrome |
| title_full_unstemmed | Less invasive surfactant administration for meconium aspiration syndrome |
| title_short | Less invasive surfactant administration for meconium aspiration syndrome |
| title_sort | less invasive surfactant administration for meconium aspiration syndrome |
| url | https://bmjpaedsopen.bmj.com/content/9/1/e003317.full |
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