Division of Pediatrics and Neonatal Critical Care, Antoine Béclère Medical Center, APHP, South Paris University Hospitals, Paris, France; Physiopathology and Therapeutic Innovation Unit-U999, South Paris-Saclay University, Paris, France.
Division of Pediatrics and Neonatal Critical Care, Antoine Béclère Medical Center, APHP, South Paris University Hospitals, Paris, France.
Lancet Child Adolesc Health. 2020 Apr;4(4):331-340. doi: 10.1016/S2352-4642(19)30405-5. Epub 2020 Feb 1.
Surfactant is a cornerstone of neonatal critical care, and the presumed less (or minimally) invasive techniques for its administration have been proposed to reduce invasiveness of neonatal critical care interventions. These techniques are generally known as less invasive surfactant administration (LISA) and have quickly gained popularity in some neonatal intensive care units. Despite the increase in the use of LISA, we believe that the pathobiological background supporting its possible clinical benefits is unclear. Similarly, it is unclear whether there are any ignored drawbacks, as LISA has been tested in only a few trials and some physiopathological issues seem to have gone unnoticed. Active research is warranted to fill these knowledge gaps before LISA can be firmly recommended. In this Viewpoint, we provide an in-depth analysis of LISA techniques, based on physiological and pathobiological factors, followed by a critical appraisal of available clinical data, and highlight some possible future research directions.
表面活性物质是新生儿重症监护的基石，人们提出了一些假定的微创技术来给药，以减少新生儿重症监护干预的侵入性。这些技术通常被称为微创表面活性物质给药（LISA），并在一些新生儿重症监护病房中迅速流行起来。尽管 LISA 的使用有所增加，但我们认为支持其可能临床益处的病理生物学背景尚不清楚。同样，尚不清楚是否存在任何被忽视的缺点，因为 LISA 仅在少数几项试验中进行了测试，一些病理生理问题似乎尚未被注意到。在 LISA 能够被坚定推荐之前，有必要进行积极的研究来填补这些知识空白。在本观点中，我们根据生理和病理生物学因素对 LISA 技术进行了深入分析，然后对现有临床数据进行了批判性评估，并强调了一些可能的未来研究方向。
