Less Invasive Surfactant Administration--A New Concept

During this 30 minute educational session I will be discussing a new procedure that we have added for our neonatal population to administer Surfactant/Curosurf without the need for endotracheal intubation. Less Invasive Surfactant Administration (LISA) is a specialized skill that has been implemented on our transport team to reduce the need for endotracheal intubation for some of our most fragile patients. Select patients in this cohort can benefit from the administration of Surfactant/Curosurf utilizing the LISA procedure to reduce the risk of barotrauma and the need for ventilatory support. Targeted neonatal patients that have been placed on Bubble CPAP (continuous positive airway pressure) and within departmental guidelines are pre-medicated with Fentanyl and “intubated” with a specialized angiocath. Utilizing the NeoView or other approved apparatus for this procedure, and are then given their dose of Surfactant/Curosurf with close monitoring and allowed to remain on Bubble CPAP. This procedure was trialed by our Neonatology group in selected hospitals prior to training our transport team. With our Neonatal Medical Directors supervision all of our Registered Nurses and Respiratory Therapists were trained on the procedure prior to implementation. Utilizing the equipment that would be used at the bedside, staff were instructed on targeted patient populations and the health benefits aimed at reducing endotracheal intubation.