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Less Invasive Surfactant Administration (LISA) in Premature Neonates, using 5F feeding tube versus 2 mm Endotracheal tube – An Innovative, Pilot study

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Abstract: Introduction: Administration of LISA using thin and soft catheters like 5 F orogastric tube, though less invasive, is technically challenging and needs expertise. We hypothesized, use of a 2 mm Endotracheal (ET) tube for administration of LISA could be an easy and convenient alternative. Methods: This is a prospective, single-centric, quasi-random, pilot trial conducted in the inborn unit of a tertiary care hospital from May 2020 - December 2020. All the inborn preterm (28 - 34 weeks) neonates with respiratory distress requiring surfactant were alternately allocated to receive LISA using a 5 F infant feeding tube or an uncuffed 2.0 size ET tube. The primary outcome was successful administration of surfactant defined as a procedure without any need for positive pressure ventilation. Results: In our study, 25 neonates were enrolled in each arm. Administration of LISA using 2 mm ET tube was associated with better success of surfactant administration with lesser incidence of PPV (20 vs 11, p < 0.05), desaturation (5 vs 12, p < 0.05), and bradycardia (3 vs 10, p < 0.05) compared to LISAOG. Conclusions: Administration of LISA using a 2 mm ET is an easily adaptable and convenient alternative that is well tolerated by the neonates without any adverse effects.

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Kalyan Chakravarthy Konda Niloufer Hospital, Osmania Medical College, Lakdikapool, Redhills, Hyderabad, Telangana, India. Swapna Lingaldinna Niloufer Hospital, Osmania Medical College, Lakdikapool, Redhills, Hyderabad, Telangana, India. Sadiqua Anjum Niloufer Hospital, Osmania Medical College, Lakdikapool, Redhills, Hyderabad, Telangana, India. Madireddy Alimelu Niloufer Hospital, Osmania Medical College, Lakdikapool, Redhills, Hyderabad, Telangana, India. Himabindu Singh Niloufer Hospital, Osmania Medical College, Lakdikapool, Redhills, Hyderabad, Telangana, India. Apoorva Tadury Niloufer Hospital, Osmania Medical College, Lakdikapool, Redhills, Hyderabad, Telangana, India.

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Endotracheal tube, Less invasive surfactant administration, preterm, Surfactant

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