Analgosedation for less-invasive surfactant administration: Variations in practice.

Autor: Muehlbacher T; Newborn Research, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland., Boos V; Newborn Research, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland., Geiger LB; Newborn Research, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland., Rüegger CM; Newborn Research, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland., Grass B; Newborn Research, Department of Neonatology, University Hospital and University of Zurich, Zurich, Switzerland.
Jazyk: angličtina
Zdroj: Pediatric pulmonology [Pediatr Pulmonol] 2024 Mar; Vol. 59 (3), pp. 750-757. Date of Electronic Publication: 2023 Dec 26.
DOI: 10.1002/ppul.26826
Abstrakt: 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.
(© 2023 The Authors. Pediatric Pulmonology published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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