Bhayat Sadaf, Kaur Avineet, Premadeva Irnthu, Reynolds Peter, Gowda Harsha
Neonatal Unit, University College London Hospitals NHS Foundation Trust, London, UK.
Neonatal Unit, Luton and Dunstable University Hospital NHS Foundation Trust, Luton, UK.
Acta Paediatr. 2020 Mar;109(3):505-510. doi: 10.1111/apa.14995. Epub 2019 Sep 16.
National survey to evaluate the uptake of Less Invasive Surfactant Administration (LISA) in neonatal units across England.
A web-based survey was sent out by email to all 150 neonatal units in England. It consisted of questions regarding indications for LISA, the practicalities of the procedure and reasons for not using this technique.
The response rate was 96% (144/150 units). Only 11% of units are using LISA, but majority (78%) would consider implementing LISA on their unit. 56% would also consider LISA on delivery suite. Challenges identified are having a guideline and staff training. 61% of units have set the target population ≥27 weeks. On sub-analysis, for tertiary units, the trend for LISA is ≥26 weeks. The median FiO threshold for LISA is 0.3 (IQR 0.3-0.4) in less than 28 weeks gestational age (GA), and 0.4 in higher gestations. The most common suggestion for premedication is fentanyl (32%).
The uptake of LISA in England is low comparing to the rest of Europe. Even though many units are considering implementing LISA, there is lack of training and national guidelines. There is urgent need for standardisation of practice and clear indications for LISA.
开展全国性调查，以评估英格兰各新生儿病房对微创表面活性剂给药法（LISA）的采用情况。
通过电子邮件向英格兰所有150个新生儿病房发送了一项基于网络的调查问卷。问卷包含有关LISA适应症、该操作的实际情况以及不使用该技术的原因等问题。
回复率为96%（144/150个病房）。只有11%的病房正在使用LISA，但大多数病房（78%）会考虑在其病房实施LISA。56%的病房还会考虑在产房使用LISA。已确定的挑战包括制定指南和进行员工培训。61%的病房将目标人群设定为≥27周。在亚组分析中，对于三级病房，LISA的趋势是≥26周。在胎龄小于28周（GA）时，LISA的中位吸氧浓度阈值为0.3（四分位间距0.3 - 0.4），在胎龄较大时为0.4。最常见的预处理建议是使用芬太尼（32%）。
与欧洲其他地区相比，LISA在英格兰的采用率较低。尽管许多病房正在考虑实施LISA，但缺乏培训和国家指南。迫切需要规范操作并明确LISA的适应症。
