Survey shows large differences between the Nordic countries in the use of less invasive surfactant administration

Abstract

Aim: Less invasive surfactant administration (LISA), namely surfactant instillation through a thin catheter in the trachea during spontaneous breathing, is increasingly used for premature infants. We surveyed the use of this technique in the Nordic countries in autumn 2015.

Methods: A link to a web-based survey of surfactant administration methods was emailed to the directors of all neonatal units in the Nordic Region, apart from Finland, where only the five university-based departments were invited.

Results: Of the 73 units (85%) who responded, 23 (32%) said that they used LISA. The country rates were Iceland 100%, Norway 82%, Finland 60%, Denmark, including Faroe Island and Greenland, 11% and Sweden 9%. LISA was used in 62% of level three units, but only 14% of level two units and most commonly in babies with a gestational age of at least 26 weeks. Premedication was always or sometimes used by 78%. The main reasons for not using LISA were lack of familiarity with the technique (61%), no perceived benefit over other methods (22%) and concerns about patient discomfort (26%).

Conclusion: Less invasive surfactant administration was used in 32% of Nordic neonatal units, most commonly in level three units. Premedication was used more often than previously reported.

Keywords: Less invasive surfactant administration; Nordic countries; Premature infants; Respiratory distress syndrome; Web-based survey.