ArticleChildren (Basel, Switzerland)2021
Introducing Less-Invasive Surfactant Administration into a Level IV NICU: A Quality Improvement Initiative.
Article in Children (Basel, Switzerland), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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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.
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Who cites it
8 citing papers in PubMed.
- 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
- Implementation of Less Invasive Surfactant Administration (LISA) for Preterm Neonates with Respiratory Distress Syndrome: A Quality Improvement Initiative: Authors' Reply.Indian journal of pediatrics · 2026Article
- Comparison of Minimally Invasive Surfactant Therapy and Intubation-surfactant Administration-extubation in Premature Neonates with Respiratory Distress Syndrome.Oman medical journal · 2025Article
- Procedural success and safety of a standardized less invasive surfactant administration protocol using fentanyl premedication and video laryngoscopy in preterm infants <32 weeks' gestation.Frontiers in pediatrics · 2025Article
- Characterizing continuous positive airway pressure (CPAP) Belly Syndrome in preterm infants in the neonatal intensive care unit (NICU).Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Less invasive surfactant administration methods: Who, what and how.Journal of perinatology : official journal of the California Perinatal Association · 2024Review
- 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
- The Intertemporal Role of Respiratory Support in Improving Neonatal Outcomes: A Narrative Review.Children (Basel, Switzerland) · 2021Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Less-invasive surfactant administration (LISA), a newer technique of delivering surfactant via a thin catheter, avoids mechanical ventilation. LISA has been widely adopted in Europe but less so in the US. Our goal was to increase the percentage of surfactant delivered via LISA from 0% to 51% by 12/2020. Project planning and literature review started 12/2019, and included a standardized equipment kit and simulation training sessions. We began Plan-Do-Study-Act (PDSA) cycles in 6/2020. Initial exclusions for LISA were gestational age (GA) <28 weeks (w) or ≥36 w, intubation in the delivery room, or PCO2 >70 if known; GA exclusion is now <25 w. From 6 to 12/2020, 97 patients received surfactant, 35 (36%) via LISA. When non-LISA-eligible patients were excluded, 35/42 (83%) received LISA successfully. There were only 2/37 patients for whom LISA was not able to be performed. Three LISA infants required mechanical ventilation in the first week of life. Sedation remained an initial challenge but improved when sucrose was used routinely. LISA was safely and successfully introduced in our NICU.
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