EAP 2021 Virtual Congress and MasterCourse

Less Invasive Surfactant Administration (LISA) In Very Prematurely Born Infants

Helen Egan 1 Peter Cornuaud 1 Anay Kulkarni 1,2 Donovan Duffy 1,2 Sandeep Shetty 1,2
1Neonatal Intensive Care Centre, St George's University Hospitals NHS Foundation Trust, London, UK
2St George's Medical School, St George's University of London, London, UK

Background: Surfactant administration improves outcomes for premature infants. The European Consensus Guidelines state that Less Invasive Surfactant Administration (LISA) is the preferred mode of surfactant administration for spontaneously breathing preterm babies. No single study has reported a reduction of BPD with LISA. LISA is used infrequently in UK neonatal units.

Objectives: To determine whether LISA on the neonatal unit or in the delivery suite improved clinical outcomes.

Methods: Historical case control comparison in a tertiary neonatal unit. Patients were twenty-five infants who received LISA (LISA infants) with a median gestational age (GA) 28 (25.6-31.7) weeks and fifty controls. Each “LISA” infant was matched with two infants (controls) who did not receive LISA. Matching was by gestational age, birth weight, sex, antenatal steroid exposure and whether they were inborn/or transferred ex utero.

Main outcome measures were need for intubation in the first 72 hours, duration of invasive and non-invasive ventilation, length of hospital stay (LOS) in days and development of bronchopulmonary dysplasia (BPD) (oxygen requirement at 36 weeks of gestation).

Results: The LISA infants had similar GAs and birth weights to the controls (28 (25.6 - 31.7) weeks versus 28.5 (25.4 - 31.9) weeks, p=0.732; 1120 (580-1810) grams versus 1070 (540-1869) grams, p=0.928). The LISA infants had a lower need for intubation (52% versus 90%, p<0.001), a shorter duration of invasive ventilation (median 1 (0-35) days versus 6 (0-62) days p=0.001) and a lower incidence of BPD (36% versus 64%, p=0.022). There were no significant differences in the duration of non-invasive ventilation (median 26 (3-225) versus 23 (2-85) days, p=0.831) or the total LOS (median 76 (24-259) versus 85 (27-221), p=0.238).

Conclusions: LISA given either on the neonatal unit or in the delivery suite was associated with a lower BPD incidence, need for intubation and duration of invasive ventilation.









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