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Objective <p>To evaluate less invasive surfactant administration (LISA) in the delivery room as a part of neonatal stabilization and reduce infants requiring intubation.</p> Project design <p>A SMART aim was developed to implement LISA in &gt;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.</p> Results <p>Over 4 years, 184 patients received LISA (<i>N</i> = 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.</p> Conclusion <p>LISA in the delivery room is safe and effective for RDS and associated with reduced need for intubation, mechanical ventilation, and BPD.</p>

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

  • 期刊论文

  • 发表日期：

    2025年7月10日

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  • 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

摘要

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.