Department of Pediatrics, University of Würzburg, Würzburg, Germany,
Department of Pediatrics, University of Cologne Children's Hospital, Cologne, Germany.
Neonatology. 2024;121(5):584-595. doi: 10.1159/000540078. Epub 2024 Sep 3.
Less invasive surfactant administration (LISA) has become the preferred method of surfactant administration for spontaneously breathing babies on continuous positive airway pressure (CPAP).
The development of LISA followed the need to combine CPAP and surfactant replacement as mainstay treatment options for respiratory distress syndrome, thereby avoided exposure to positive pressure ventilation.
This review summarises the current knowns and unknowns of LISA including the physiological concept, its relevance for short-term and long-term outcomes and the challenges for practical implementation of LISA as part of a less invasive respiratory care bundle. Further, we provide an update of the evidence on alternatives to LISA, for example, nebulised surfactant administration, pharyngeal deposition of surfactant and delivery via supraglottic airway.
对于接受持续气道正压通气（CPAP）治疗的自主呼吸婴儿，微创表面活性剂给药（LISA）已成为表面活性剂给药的首选方法。
LISA 的发展是为了将 CPAP 和表面活性剂替代联合作为呼吸窘迫综合征的主要治疗选择，从而避免了暴露于正压通气中。
本综述总结了 LISA 的当前已知和未知内容，包括生理概念、其对短期和长期结局的相关性，以及将 LISA 作为微创呼吸护理综合治疗包的一部分实际应用的挑战。此外，我们还提供了对 LISA 替代方法的最新证据，例如，雾化表面活性剂给药、表面活性剂在咽部的沉积以及通过声门上气道给药。
