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Less Invasive Surfactant Administration: A Review of Current Evidence of Clinical Outcomes With Beractant
Evidence supporting clinical recommendations or approval for less invasive surfactant administration (LISA) has primarily examined heterogeneous or small-volume (e.g., 1.25-2.5 mL/kg) animal-derived surfactant regimens. To address the evidence gap for larger-volume (e.g., 4-5 mL/kg) animal-derived s...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Cureus
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9651081/ https://www.ncbi.nlm.nih.gov/pubmed/36381708 http://dx.doi.org/10.7759/cureus.30223 |
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author | Sanchez Luna, Manuel Unnebrink, Kristina Martinez-Tristani, Marisol Ramos Navarro, Cristina |
author_facet | Sanchez Luna, Manuel Unnebrink, Kristina Martinez-Tristani, Marisol Ramos Navarro, Cristina |
author_sort | Sanchez Luna, Manuel |
collection | PubMed |
description | Evidence supporting clinical recommendations or approval for less invasive surfactant administration (LISA) has primarily examined heterogeneous or small-volume (e.g., 1.25-2.5 mL/kg) animal-derived surfactant regimens. To address the evidence gap for larger-volume (e.g., 4-5 mL/kg) animal-derived surfactants, the aim of this review was to evaluate and summarize LISA literature for widely used larger-volume beractant. Surfactant treatment and the LISA technique were initially summarized. The available literature on beractant with LISA was thoroughly assessed and reviewed, including a recent systematic analysis, studies from regions where access or preferences may influence reliance on larger-volume surfactants, and investigations of short- and long-term outcomes. The available literature indicated improved short-term outcomes, including less need for mechanical ventilation, death, or bronchopulmonary dysplasia, and no negative long-term developmental outcomes when beractant was administered via LISA compared with older, more invasive techniques. The rates of short-term outcomes were similar to those previously observed in examinations of LISA with small-volume surfactants, including in populations reflecting very preterm infants. As uptake of LISA is expected to increase, future research directions for larger-volume surfactants include cost-effectiveness evaluations and robust examinations of repeat dosing and surfactant reflux to further inform clinical practice. This review provides a detailed assessment of the literature describing surfactant and LISA, with a focus on studies of beractant. Collectively, the available evidence supports the use of beractant with LISA based both on short-term and long-term outcomes relative to more invasive techniques and comparability of outcomes with small-volume surfactants and may be valuable in guiding clinical decision-making. |
format | Online Article Text |
id | pubmed-9651081 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-96510812022-11-14 Less Invasive Surfactant Administration: A Review of Current Evidence of Clinical Outcomes With Beractant Sanchez Luna, Manuel Unnebrink, Kristina Martinez-Tristani, Marisol Ramos Navarro, Cristina Cureus Pediatrics Evidence supporting clinical recommendations or approval for less invasive surfactant administration (LISA) has primarily examined heterogeneous or small-volume (e.g., 1.25-2.5 mL/kg) animal-derived surfactant regimens. To address the evidence gap for larger-volume (e.g., 4-5 mL/kg) animal-derived surfactants, the aim of this review was to evaluate and summarize LISA literature for widely used larger-volume beractant. Surfactant treatment and the LISA technique were initially summarized. The available literature on beractant with LISA was thoroughly assessed and reviewed, including a recent systematic analysis, studies from regions where access or preferences may influence reliance on larger-volume surfactants, and investigations of short- and long-term outcomes. The available literature indicated improved short-term outcomes, including less need for mechanical ventilation, death, or bronchopulmonary dysplasia, and no negative long-term developmental outcomes when beractant was administered via LISA compared with older, more invasive techniques. The rates of short-term outcomes were similar to those previously observed in examinations of LISA with small-volume surfactants, including in populations reflecting very preterm infants. As uptake of LISA is expected to increase, future research directions for larger-volume surfactants include cost-effectiveness evaluations and robust examinations of repeat dosing and surfactant reflux to further inform clinical practice. This review provides a detailed assessment of the literature describing surfactant and LISA, with a focus on studies of beractant. Collectively, the available evidence supports the use of beractant with LISA based both on short-term and long-term outcomes relative to more invasive techniques and comparability of outcomes with small-volume surfactants and may be valuable in guiding clinical decision-making. Cureus 2022-10-12 /pmc/articles/PMC9651081/ /pubmed/36381708 http://dx.doi.org/10.7759/cureus.30223 Text en Copyright © 2022, Sanchez Luna et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Pediatrics Sanchez Luna, Manuel Unnebrink, Kristina Martinez-Tristani, Marisol Ramos Navarro, Cristina Less Invasive Surfactant Administration: A Review of Current Evidence of Clinical Outcomes With Beractant |
title | Less Invasive Surfactant Administration: A Review of Current Evidence of Clinical Outcomes With Beractant |
title_full | Less Invasive Surfactant Administration: A Review of Current Evidence of Clinical Outcomes With Beractant |
title_fullStr | Less Invasive Surfactant Administration: A Review of Current Evidence of Clinical Outcomes With Beractant |
title_full_unstemmed | Less Invasive Surfactant Administration: A Review of Current Evidence of Clinical Outcomes With Beractant |
title_short | Less Invasive Surfactant Administration: A Review of Current Evidence of Clinical Outcomes With Beractant |
title_sort | less invasive surfactant administration: a review of current evidence of clinical outcomes with beractant |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9651081/ https://www.ncbi.nlm.nih.gov/pubmed/36381708 http://dx.doi.org/10.7759/cureus.30223 |
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