Trial reportJournal of perinatology : official journal of the California Perinatal Association2004
Technique for intrapartum administration of surfactant without requirement for an endotracheal tube.
Trial report in Journal of perinatology : official journal of the California Perinatal Association, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 124 citations in OpenAlex.
- Laryngeal mask airway surfactant administration for prevention of morbidity and mortality in preterm infants with or at risk of respiratory distress syndrome.The Cochrane database of systematic reviews · 2024Pooled it
- Nebulised surfactant in preterm infants with or at risk of respiratory distress syndrome.The Cochrane database of systematic reviews · 2012Pooled it
- Pharyngeal instillation of surfactant before the first breath for prevention of morbidity and mortality in preterm infants at risk of respiratory distress syndrome.The Cochrane database of systematic reviews · 2011Pooled it
- Intra-amniotic surfactant for women at risk of preterm birth for preventing respiratory distress in newborns.The Cochrane database of systematic reviews · 2010Pooled it
- Less invasive surfactant administration via infant feeding tube versus InSurE method in preterm infants: a randomized control trial.Scientific reports · 2022Trial
- The OPTIMIST-A trial: evaluation of minimally-invasive surfactant therapy in preterm infants 25-28 weeks gestation.BMC pediatrics · 2014Trial
- Prophylactic Oropharyngeal Surfactant for Preterm Newborns at Birth: A Randomized Clinical Trial.JAMA pediatrics · 2024Article
- Evaluation of methods of surfactant administration in the delivery suite?Archives of medical science : AMS · 2023Article
- Alternative Methods of Surfactant Administration in Preterm Infants with Respiratory Distress Syndrome: State of the Art.Turkish archives of pediatrics · 2021Article
- The Comparison of LISA and INSURE techniques in term of neonatal morbidities and mortality among premature infants.Acta bio-medica : Atenei Parmensis · 2020Article
- Study protocol for the POPART study-Prophylactic Oropharyngeal surfactant for Preterm infants: A Randomised Trial.BMJ open · 2020Article
- Cerebral oxygenation associated with INSURE versus LISA procedures in surfactant-deficient newborn piglet RDS model.Pediatric pulmonology · 2019Article
- Update of minimally invasive surfactant therapy.Korean journal of pediatrics · 2017Review
- Effect of Surfactant Therapy Using Orogastric Tube for Tracheal Catheterization in Preterm Newborns with Respiratory Distress.Indian journal of pediatrics · 2017Observational
- Less Invasive Surfactant Administration Reduces the Need for Mechanical Ventilation in Preterm Infants: A Meta-Analysis.Global pediatric health · 2017Article
- Less invasive beractant administration in preterm infants: a pilot study.Clinics (Sao Paulo, Brazil) · 2016Article
- The Implications of Metabotypes for Rationalizing Therapeutics in Infants and Children.Frontiers in pediatrics · 2015Review
- A comparison of surfactant administration through i-gel and ET-tube in the treatment of respiratory distress syndrome in newborns weighing more than 2000 grams.Advanced biomedical research · 2014Article
- Exogenous surfactant therapy in 2013: what is next? Who, when and how should we treat newborn infants in the future?BMC pediatrics · 2013Review
- Delivery and performance of surfactant replacement therapies to treat pulmonary disorders.Therapeutic delivery · 2013Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the feasibility and safety of administering surfactant into the nasopharynx during delivery, thus permitting the baby to aspirate the solution into the fluid-filled airway as an air-fluid interface is established. This process avoids the endotracheal intubation (ETI) and positive pressure ventilation (PPV) usually associated with prophylaxis, thus avoiding the pulmonary barotrauma associated with the conventional method of surfactant administration. STUDY
designIn all, 23 neonates weighing 560 to 1804 g and born at 27 to 30 weeks had their nasopharyngeal airways suctioned and then 3.0-4.5 ml Infasurf instilled into the nasopharynx before delivery of the shoulders. Continuous positive airway pressure (CPAP) of 10 cmH(2)O was administered by mask as the babies initiated breathing. Nasal CPAP at 6 cmH(2)O was then continued for a minimum of 48 hours.
resultsIn all, 13 of 15 babies delivered vaginally were weaned quickly to room air and required no further surfactant or endotracheal intubation for RDS. Five of eight babies delivered by C-section required subsequent endotracheal intubation soon after birth and two received subsequent endotracheal tube surfactant.
conclusionNasopharyngeal surfactant instillation at birth appears to be relatively safe and simple to accomplish, especially for vaginal births. A large randomized clinical trial will be required to determine the efficacy of this technique when compared to prophylaxis by endotracheal intubation and to nCPAP alone.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.