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. 2024 Mar;59(3):750-757.
doi: 10.1002/ppul.26826. Epub 2023 Dec 26.

Analgosedation for less-invasive surfactant administration: Variations in practice

Tobias Muehlbacher  1 , Vinzenz Boos  1 , Leonie-Beatrice Geiger  1 , Christoph M Rüegger  1 , Beate Grass  1
Affiliations

Analgosedation for less-invasive surfactant administration: Variations in practice

Tobias Muehlbacher et al. Pediatr Pulmonol. 2024 Mar.

Abstract

Background: Less-invasive surfactant administration (LISA) is widely used for surfactant delivery to spontaneously breathing preterm infants on nasal CPAP. However, the use of analgesia and/or sedation for the LISA procedure remains controversial.

Methods: We conducted a cross-sectional survey of all tertiary neonatal intensive care units (NICUs) in Austria, Germany, and Switzerland to assess current practices of analgosedation for LISA in preterm infants.

Results: Eighty-eight of 172 (51.2%) NICUs responded to the survey, of which 83 (94.3%) perform LISA. Analgosedation for LISA is used in 60 (72.3%) NICUs. Twenty-eight of those (46.7%) have unit protocols to guide analgosedation while 32 (53.3%) administer medication at the discretion of the attending physician. Ketamine (45.0% of NICUs), propofol (41.7%), fentanyl (21.7%), morphine (20.0%), and midazolam (20.0%) were most frequently used for analgosedation for LISA. Nine (10.7%) NICUs reported the use of pain or distress scores during LISA.

Conclusion: LISA is well established among tertiary NICUs in the German-speaking countries. However, there are considerable variations regarding the use of analgosedation. More evidence is required to guide clinicians seeking to safely and effectively deliver surfactant via a thin catheter to spontaneously breathing preterm infants.

Keywords: LISA; analgosedation; preterm infant; surfactant.

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References

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