Less invasive surfactant administration in the delivery room: A quality improvement initiative.

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-07-10 DOI:10.1038/s41372-025-02350-w

Jonathan R Burris, Blair F Germain, Patricia R Chess, Elizabeth A Powers, Rebecca Gillis, Hyacinth G Lewis, Jamey Tulloch, Colby L Day, Andrew M Dylag

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引用次数: 0

Abstract

Objective: To evaluate less invasive surfactant administration (LISA) in the delivery room as a part of neonatal stabilization and reduce infants requiring intubation.

Project design: A SMART aim was developed to implement LISA in >30% of infants (25.0-31.6 weeks' gestational age) with respiratory distress syndrome (RDS) in the NICU or delivery room (DR) and increase the number of infants never requiring intubation by 50% by 12/31/2023. Three sequential Plan-Do-Study-Act cycles were implemented. Statistical Process Control charts tracked time-ordered data.

Results: Over 4 years, 184 patients received LISA (N = 112 in the DR). LISA was safe and successful (98.9%), including DR. DR intubations were reduced (65.5 to 52.6%), infants never requiring intubation increased (22.8 to 38%), and Grade 2 or 3 BPD (12.9 to 8.8%) was reduced.

Conclusion: LISA in the delivery room is safe and effective for RDS and associated with reduced need for intubation, mechanical ventilation, and BPD.

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产房中微创表面活性剂的使用：一项质量改进倡议。

目的：探讨在产房采用微创表面活性剂给药（LISA）作为新生儿稳定和减少新生儿插管需求的一部分。项目设计：制定SMART目标，到2023年12月31日，在NICU或产房（DR）有呼吸窘迫综合征（RDS）的婴儿（25.0-31.6周）中实施LISA，并将不需要插管的婴儿数量增加50%。实施了三个连续的计划-执行-研究-行动循环。统计过程控制图表跟踪时间顺序数据。结果：4年多来，184例患者接受了LISA治疗（DR组112例）。LISA是安全和成功的（98.9%），包括DR在内的DR插管减少（65.5%至52.6%），从不需要插管的婴儿增加（22.8%至38%），2级或3级BPD（12.9%至8.8%）减少。结论：产房LISA对RDS是安全有效的，可减少插管、机械通气和BPD的需要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.