A Survey of Minimally Invasive Surfactant Therapy in Canada

Overview

Journal Can J Respir Ther

Date 2022 Aug 11

PMID 35950171

Authors

Shaily Brahmbhatt

Brooke Read

Orlando da Silva

Soume Bhattacharya

Affiliations

Soon will be listed here.

Abstract

Introduction: Minimally invasive surfactant therapy (MIST) can be used to treat neonatal respiratory distress syndrome in neonatal intensive care units (NICUs). Clinical and institutional variances in MIST utilization persist globally with little published research regarding MIST utilization in Canada. Therefore, the objective of this study was to survey MIST utilization in NICUs in Canada.

Methods: An online survey was emailed to the 33 participating centres of Canadian Neonatal Network (CNN) Evidence-based Practice for Improving Quality (EPIQ) Lung Health Group (LHG). Site demographics and surfactant therapy procedural details were categorically collected. Free text and multiple-choice questions were utilized to capture perceived barriers and individual preferences for MIST use.

Results: Twenty-eight of 33 participating members of the CNN EPIQ-LHG completed the survey between April 2021 and October 2021 (85%); 17/28 (61%) respondents reported ongoing MIST utilization at their center. Most centers that used MIST techniques administered bovine lipid extract surfactant (68%), commonly using angiocatheters (47%) and purpose-built catheters (41%). MIST was widely used for patients at 26-33 weeks gestational age (88%). Nine centres had never used MIST (32%), and 3 indicated a plan to implement MIST within the next 2 years. Common barriers to MIST use included lack of consensus amongst clinicians (78%), lack of training (56%), and lack of experience with MIST (56%).

Conclusion: While MIST is being increasingly used in Canadian NICUs, universal use is yet to be seen. Clinician inexperience and lack of consensus, formal training, and local guidelines contribute to underutilization of MIST. Training workshops, country-wide data collection, and uniform operating protocols are needed to standardize practice.

Citing Articles

Application of Video Laryngoscopy for Minimally Invasive Surfactant Therapy: A Retrospective Comparative Cohort Study.

Jahmani T, Miller M, da Silva O, Bhattacharya S Biomedicines. 2024; 12(3).

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Purpose Built Catheters for Minimally Invasive Surfactant Therapy: Experience from a Canadian Tertiary Level Neonatal Intensive Care Unit.

Al Harthy T, Miller M, DaSilva O, Bhattacharya S Can J Respir Ther. 2023; 59:137-144.

PMID: 37781350 PMC: 10540161. DOI: 10.29390/001c.77606.

Less invasive surfactant administration methods: Who, what and how.

Guthrie S, Roberts K J Perinatol. 2023; 44(4):472-477.

PMID: 37737494 DOI: 10.1038/s41372-023-01778-2.

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