Clinical evaluation of an application aid for less-invasive surfactant administration (LISA)

Background Less-invasive surfactant administration (LISA) is increasingly used. We investigated the feasibility of a new LISA-device (Neofact (R)) in neonates. Design Prospective observational pilot study with open-label LISA in two tertiary neonatal intensive care units. Patients 20 infants with a gestational age of >= 26+0/7 weeks and an indication for LISA (Respiratory Severity Score (RSS)>= 5 or fraction of inspired oxygen (FiO(2)) >= 0.30). Infants with respiratory tract malformations or unavailability of an instructed neonatologist were excluded. Main outcome measures Success of LISA, defined as laryngoscopy-confirmed intratracheal catheter position or a decrease in FiO(2) by >= 0.05 or to 0.21, accompanied by an RSS decrease of >= 2; number of attempts needed for tracheal catheterisation. Results 20/57 screened infants were enrolled. Successful application occurred in 19/20 (95%). One application failed after three attempts. No device-related adverse events occurred. The median number of attempts was 2, success rate per attempt 19/31 (61%). Conclusion LISA via Neofact (R) appears feasible.