Laryngeal Mask Airway for Surfactant Administration in Neonates

A Randomized, Controlled Trial

Kari D Roberts, Roland Brown, Andrea L. Lampland, Tina A. Leone, Kyle Rudser, Neil N. Finer, Wade D. Rich, T. Allen Merritt, Adam J. Czynski, Julie M. Kessel, Sajani M. Tipnis, Erin C Stepka, Mark C. Mammel

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: To determine if preterm infants with moderate respiratory distress syndrome on continuous positive airway pressure (CPAP) who received surfactant via a laryngeal mask airway (LMA) would have a decreased rate of intubation and mechanical ventilation compared with those on CPAP who did not receive surfactant. Study design: In this prospective, multicenter, randomized controlled trial, 103 premature infants 28 0/7 -35 6/7 weeks gestation, ≥1250 g and ≤36 hours old on CPAP requiring fraction of inspired oxygen 0.30-0.40 were assigned to receive surfactant administered through an LMA then placed back on CPAP (LMA group) or maintained on CPAP with no surfactant administered (control group). The primary outcome was treatment failure necessitating intubation and mechanical ventilation in the first 7 days of life. Results: Surfactant administration through an LMA (n = 50) significantly decreased the rate of intubation and mechanical ventilation compared with controls (n = 53): 38% vs 64%, respectively, OR 0.30 (95% CI 0.13, 0.70), P =.006, number needed to treat: 4). There were no serious adverse events associated with placement of the LMA or surfactant administration. Conclusions: In premature neonates with moderate respiratory distress syndrome, surfactant administered through an LMA decreased the rate of intubation and mechanical ventilation. This intervention may have significant impact on clinical care in both high and low resource settings. Trial registration: ClinicalTrials.gov: NCT01116921.

Original languageEnglish (US)
Pages (from-to)40-46.e1
JournalJournal of Pediatrics
Volume193
DOIs
StatePublished - Feb 1 2018

Fingerprint

Laryngeal Masks
Surface-Active Agents
Continuous Positive Airway Pressure
Randomized Controlled Trials
Newborn Infant
Artificial Respiration
Intubation
Premature Infants
Numbers Needed To Treat
Treatment Failure
Oxygen
Pregnancy
Control Groups

Keywords

  • infant
  • intubation
  • preterm
  • respiratory distress syndrome

PubMed: MeSH publication types

  • Journal Article
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

Cite this

Laryngeal Mask Airway for Surfactant Administration in Neonates : A Randomized, Controlled Trial. / Roberts, Kari D; Brown, Roland; Lampland, Andrea L.; Leone, Tina A.; Rudser, Kyle; Finer, Neil N.; Rich, Wade D.; Merritt, T. Allen; Czynski, Adam J.; Kessel, Julie M.; Tipnis, Sajani M.; Stepka, Erin C; Mammel, Mark C.

In: Journal of Pediatrics, Vol. 193, 01.02.2018, p. 40-46.e1.

Research output: Contribution to journalArticle

Roberts, KD, Brown, R, Lampland, AL, Leone, TA, Rudser, K, Finer, NN, Rich, WD, Merritt, TA, Czynski, AJ, Kessel, JM, Tipnis, SM, Stepka, EC & Mammel, MC 2018, 'Laryngeal Mask Airway for Surfactant Administration in Neonates: A Randomized, Controlled Trial', Journal of Pediatrics, vol. 193, pp. 40-46.e1. https://doi.org/10.1016/j.jpeds.2017.09.068
Roberts, Kari D ; Brown, Roland ; Lampland, Andrea L. ; Leone, Tina A. ; Rudser, Kyle ; Finer, Neil N. ; Rich, Wade D. ; Merritt, T. Allen ; Czynski, Adam J. ; Kessel, Julie M. ; Tipnis, Sajani M. ; Stepka, Erin C ; Mammel, Mark C. / Laryngeal Mask Airway for Surfactant Administration in Neonates : A Randomized, Controlled Trial. In: Journal of Pediatrics. 2018 ; Vol. 193. pp. 40-46.e1.
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