Trial reportJournal of perinatology : official journal of the California Perinatal Association2016
Randomized trial of laryngeal mask airway versus endotracheal intubation for surfactant delivery.
Trial report in Journal of perinatology : official journal of the California Perinatal Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 38 papers, 3 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
38 citing papers in PubMed, 3 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Comparative efficacy and safety of pulmonary surfactant delivery strategies in neonatal RDS: a network meta-analysis.BMC pulmonary medicine · 2024Pooled it
- 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
- Laryngeal mask airway versus bag-mask ventilation or endotracheal intubation for neonatal resuscitation.The Cochrane database of systematic reviews · 2018Pooled it
- Comparison of laryngeal mask airway and endotracheal tube placement in neonates.Journal of perinatology : official journal of the California Perinatal Association · 2024Trial
- Nebulised surfactant to reduce severity of respiratory distress: a blinded, parallel, randomised controlled trial.Archives of disease in childhood. Fetal and neonatal edition · 2019Trial
- Efficacy of laryngeal mask epinephrine in neonatal resuscitation; an ovine study.Pediatric research · 2026Article
- Development of a New Aerosol Delivery System for Administering Aerosol Surfactant Therapy to Preterm Infants Through a Laryngeal Mask Airway.AAPS PharmSciTech · 2026Article
- Improving LISA Practice: An Ongoing Observational Quality Improvement Initiative Following Initiation of Less-Invasive Surfactant Administration in a Level IV NICU.Children (Basel, Switzerland) · 2026Article
- The AerVia supraglottic airway device versus the endotracheal tube in neonatal delivery room resuscitation: a prospective cohort study.Frontiers in pediatrics · 2026Article
- Article
- Confirmation of successful supraglottic airway device placement in neonates using a respiratory function monitor.Pediatric research · 2025Article
- Characterization of atomization and delivery efficiency of exogenous surfactant in preterm infant lungs using an ex vivo respiratory model.Scientific reports · 2025Article
- Laryngeal Mask Airway Method for Minimally Invasive Surfactant Therapy in Neonates with Pneumothorax Complicating Respiratory Distress Syndrome.Children (Basel, Switzerland) · 2025Article
- Feasibility and safety of surfactant administration via laryngeal mask airway as first-line therapy for a select newborn population: results of a standardized clinical protocol.Journal of perinatology : official journal of the California Perinatal Association · 2025Observational
- Laryngeal Mask for Minimally-invasive Surfactant Administration: A Narrative Review.Current pediatric reviews · 2025Review
- Less Invasive Surfactant Administration: A Viewpoint.American journal of perinatology · 2024Review
- Supraglottic airway devices: a powerful strategy in airway management.American journal of cancer research · 2024Review
- Clinical decision thresholds for surfactant administration in preterm infants: a systematic review and network meta-analysis.EClinicalMedicine · 2023Article
- RDS-NExT workshop: consensus statements for the use of surfactant in preterm neonates with RDS.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
- Should less invasive surfactant administration (LISA) become routine practice in US neonatal units?Pediatric research · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare the effectiveness of surfactant delivery via endotracheal tube (ETT) using an intubation-surfactant-rapid extubation approach with premedication) vs laryngeal mask airway (LMA) in preventing the need for mechanical ventilation in preterm neonates with moderate respiratory distress syndrome (RDS). STUDY
designModerately preterm infants diagnosed with RDS, receiving nasal continuous positive airway pressure with FiO2 0.30 to 0.60, were randomized to two groups at age 3 to 48 h. Those in the ETT group were intubated following premedication with atropine and morphine, whereas the LMA group received only atropine. Both groups received calfactant before a planned reinstitution of nasal continuous positive airway pressure, and had equivalent pre-specified criteria for subsequent mechanical ventilation and surfactant retreatment. The primary outcome was failure of surfactant treatment strategy to avoid mechanical ventilation; we differentiated early from late failures to assess the contribution of potential mechanisms such as respiratory depression versus less-effective surfactant delivery. Secondary outcomes addressed efficacy and safety end points.
resultSixty-one patients were randomized, one excluded and 30 analyzed in each group, with similar baseline characteristics. Failure rate was 77% in the ETT group and 30% in the LMA group (P<0.001). The difference was related to early failure, as late failure rates did not differ between groups. FiO2 decrease after surfactant and rates of adverse events were similar between groups.
conclusionSurfactant therapy through an LMA decreases the proportion of newborns with moderate RDS who require mechanical ventilation, when compared with a standard endotracheal intubation procedure with sedation. The efficacy of surfactant in decreasing RDS severity appears similar with both methods. Morphine premedication likely contributed to early post-surfactant failures.
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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.