Quality assessment and response to less invasive surfactant administration (LISA) without sedation.
Biomarkers
/ blood
Birth Weight
Catheters
Gestational Age
Heart Rate
Humans
Hypnotics and Sedatives
/ therapeutic use
Infant, Extremely Premature
Infant, Newborn
Infant, Very Low Birth Weight
Laryngoscopy
/ adverse effects
Lung
/ drug effects
Oxygen
/ blood
Prospective Studies
Pulmonary Surfactants
/ administration & dosage
Quality Indicators, Health Care
Respiratory Distress Syndrome, Newborn
/ diagnosis
Time Factors
Treatment Failure
Journal
Pediatric research
ISSN: 1530-0447
Titre abrégé: Pediatr Res
Pays: United States
ID NLM: 0100714
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
received:
10
05
2019
accepted:
16
08
2019
revised:
24
07
2019
pubmed:
27
8
2019
medline:
26
1
2021
entrez:
27
8
2019
Statut:
ppublish
Résumé
Although sedative premedication for endotracheal intubation is considered standard of care, less invasive surfactant administration (LISA) is often performed without sedative premedication. The aim of this study was to assess success rates, technical quality and vital parameters in LISA without sedative premedication. Prospective observational study in 86 neonates <32 weeks' gestation. LISA was performed according to a standardized protocol without use of sedative premedication. Outcome measures were success rates of LISA attempts, reasons for failure and quality of technical conditions. In 37 neonates, heart rate and oxygen saturation levels from 20 min before until 30 min after start of LISA were collected. In 48% of LISAs the first attempt failed and in 34% quality of technical conditions was inadequate. The success rate was significantly correlated with quality of technical conditions and experience of the performer. Desaturations <80% occurred in 54% of patients while bradycardia <80/min did not occur. This study shows a relatively low success rate of the first attempt of LISA, frequent inadequacy of technical quality and frequent oxygen desaturations. These effects may be improved by the use of sedative premedication.
Sections du résumé
BACKGROUND
Although sedative premedication for endotracheal intubation is considered standard of care, less invasive surfactant administration (LISA) is often performed without sedative premedication. The aim of this study was to assess success rates, technical quality and vital parameters in LISA without sedative premedication.
METHODS
Prospective observational study in 86 neonates <32 weeks' gestation. LISA was performed according to a standardized protocol without use of sedative premedication. Outcome measures were success rates of LISA attempts, reasons for failure and quality of technical conditions. In 37 neonates, heart rate and oxygen saturation levels from 20 min before until 30 min after start of LISA were collected.
RESULTS
In 48% of LISAs the first attempt failed and in 34% quality of technical conditions was inadequate. The success rate was significantly correlated with quality of technical conditions and experience of the performer. Desaturations <80% occurred in 54% of patients while bradycardia <80/min did not occur.
CONCLUSION
This study shows a relatively low success rate of the first attempt of LISA, frequent inadequacy of technical quality and frequent oxygen desaturations. These effects may be improved by the use of sedative premedication.
Identifiants
pubmed: 31450233
doi: 10.1038/s41390-019-0552-z
pii: 10.1038/s41390-019-0552-z
pmc: PMC7223491
doi:
Substances chimiques
Biomarkers
0
Hypnotics and Sedatives
0
Pulmonary Surfactants
0
Oxygen
S88TT14065
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
125-130Références
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