美国使用微创表面活性剂给药（LISA）并文献复习。
The use of less invasive surfactant administration (LISA) in the United States with review of the literature.
机构信息
Cohen Children's Medical Center, New Hyde Park, NY, USA.
University of Texas Southwestern Medical Center, Dallas, TX, USA.
出版信息
J Perinatol. 2019 Mar;39(3):426-432. doi: 10.1038/s41372-018-0302-9. Epub 2019 Jan 11.
BACKGROUND
The majority of extremely low gestational age neonates undergo intubation for surfactant therapy. Less invasive surfactant administration (LISA) uses a thin catheter inserted into the trachea to deliver the surfactant. During the procedure, the infant is breathing spontaneously while supported with continuous positive airway pressure. Although LISA is widely adapted in Europe and Australia, the rate of LISA use in the United States is unknown.
STUDY DESIGN
The aim of this study is to evaluate the use of LISA in the US. A web-based survey was distributed via SurveyMonkey to 2550 neonatologists from AAP's SoNPM mailing list.
RESULTS
Of the 472 neonatologists who answered the survey, 15% used LISA either as a part of routine care (8%) or as part of research (7%).
CONCLUSION
Unlike several regions of Europe, LISA is not widely used in the US. Future studies should address ambiguities regarding infant selection, procedure training and "roadblocks" to its broader application.
背景
大多数极低胎龄的新生儿需要接受气管插管以接受表面活性剂治疗。经鼻持续气道正压通气（NCPAP）联合肺表面活性物质（PS）气管内滴入（INSURE）技术是一种新的治疗新生儿呼吸窘迫综合征（NRDS）的方法，即经鼻间歇正压通气（NIPPV）联合肺表面活性物质（PS）气管内滴入（INSURE）技术，与传统的气管插管、机械通气联合 PS 治疗相比，可显著降低早产儿气管插管率及呼吸机相关性肺损伤。
研究设计
本研究旨在评估 LISA 在美 国的使用情况。通过 SurveyMonkey 网站向 AAP 的 SoNPM 邮件列表中的 2550 名新生儿科医生发放了网络调查。
结果
在回答调查的 472 名新生儿科医生中，有 15%的医生将 LISA 作为常规护理（8%）或研究的一部分（7%）。
结论
与欧洲的几个地区不同，LISA 在美国尚未广泛应用。未来的研究应解决关于婴儿选择、程序培训以及限制其更广泛应用的障碍等问题。
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