Ellen de Kort

55 Less Invasive Surfactant Administration without sedation 4 In accordance with the NEAR4KIDS registry definitions of intubation encounters and attempts, 29 we defined a LISA procedure as one complete procedure of airway management intervention including the administration of surfactant. An attempt was defined as one episode of laryngoscopy, beginningwith the insertion of the laryngoscope into the patient’s mouth and ending when the laryngoscope was removed. A successful attempt was defined as an episode of laryngoscopy in which the complete amount of surfactant could be administered. An attempt failed if not the complete dose of surfactant could be administered and another laryngoscopy episode was needed to complete surfactant administration. Quality of technical conditions was assessed by the operator of the procedurewith theViby-Mogensen intubation score. 30 One missing itemwas allowed, if more than one item of the intubation score was missing, quality of technical conditions could not be judged. Good technical quality was defined as a score on each item ≤2. A score on one or more items ≥3 implied inadequate technical quality. Vital parameters In all infants admitted to the NICU vital parameters are continuously monitored using Intellivue MXI 800 patient monitors (Philips, Hamburg, Germany). All data are saved to a data warehouse system with a sampling rate of 1 Hz. For the purpose of this study, data were extracted from 20 min before until 30 min after start of the LISA procedure. Data were averaged per minute. Baseline heart rate and oxygen saturation were calculated as median heart rate and oxygen saturation in the period from 20 min to 10 min before start of the LISA procedure. The period from 10 min before to start of the LISA procedure was discarded as in this period atropine was administered and nursing handling was needed to install the patient properly for the LISA procedure. Changes in heart rate and oxygen saturation in the 30 min after the start of LISA in relation to baseline were calculated. Besides this, changes in heart rate and oxygen saturation after the start of LISA comparedwith baseline were calculated for patients with good versus patients with inadequate technical quality, and for patients with success versus patients with failure of the first attempt. Statistical analysis SPSS (IBMSPSS Statistics forWindows, version 22.0, Armonk, NY, USA) was used to analyze the data. Relevant patient data were reported as numbers with percentages for qualitative variables and median and interquartile ranges for quantitative variables. Comparison between groups was performed with the Mann–Whitney U test for continuous variables and the Pearson Chi square test or Fisher’s exact test, as appropriate, for categorical variables. Comparison of vital parameters between baseline and different time points after baseline within the same group of patients was performed with a paired t-test.