Ellen de Kort

ABSTRACT Background: Although sedative premedication for endotracheal intubation is considered standard of care, less invasive surfactant administration (LISA) is often performedwithout sedative premedication. The aimof this studywas to assess success rates, technical quality and vital parameters in LISA without sedative premedication. Methods: Prospective observational study in 86 neonates <32 weeks’ gestation. LISA was performed according to a standardized protocol without use of sedative premedication. Outcome measures were success rates of LISA attempts, reasons for failure and quality of technical conditions. In 37 neonates, heart rate and oxygen saturation levels form 20 min before until 30 min after start of LISA were collected. Results: In 48% of LISAs the first attempt failed and in 41% quality of technical conditions was inadequate. The success ratewas significantly correlatedwith quality of technical conditions and experience of the performer. Desaturations <80% occurred in 54% of patients while bradycardia <80/min did not occur. Conclusion: This study shows a relatively low success rate of the first attempt of LISA, frequent inadequacy of technical quality and frequent oxygen desaturations. These effects may be improved by the use of sedative premedication.