英国新生儿病房微创表面活性剂给药（LISA）实践的变化
Changes in practice of less-invasive surfactant administration (LISA) in United Kingdom neonatal units.
作者信息
Shetty Sandeep, Tolentino Donna, Lau Cheryl, Duffy Donovan, Greenough Anne
机构信息
Neonatal Intensive Care Centre, St George's University Hospitals NHS Foundation Trust, London, UK.
St George's University of London, London, UK.
出版信息
Acta Paediatr. 2025 Feb;114(2):393-397. doi: 10.1111/apa.17446. Epub 2024 Oct 8.
AIM
To determine whether the use of less-invasive surfactant administration (LISA) had changed between 2018 and 2024.
METHODS
An online questionnaire was sent to all 191 neonatal units between June 2023 and May 2024. One consultant from each neonatal unit was randomly selected. Follow-up was done by telephone (middle-grade doctor grade and above or alternatively to Advanced Neonatal Nurse Practitioners) for the non-responders.
RESULTS
Response rate was 100%from 191 units neonatal units. LISA was used in 134 (70%) neonatal units in 2024 compared to 35 (18.7%) units in 2018 (p < 0.001). The reason why LISA was not performed was lack of experience/training (51%) or not having a standardised practice/guideline (49%). LISA in the delivery suite (DS) had increased from 2% in 2018 to 16% in 2024, and the use of video laryngoscope for LISA is becoming standard of practice. The oxygen requirement criteria for the use of LISA in both the DS and on neonatal unit had reduced to FiO2 of 0.3 or more.
CONCLUSION
The uptake of LISA had increased in the United Kingdom. There is greater use of LISA in the DS. Lack of training and expertise were the major limiting factors for LISA not being performed.
目的
确定2018年至2024年间，微创表面活性剂给药（LISA）的使用情况是否发生了变化。
方法
在2023年6月至2024年5月期间，向所有191个新生儿病房发送了在线调查问卷。每个新生儿病房随机挑选一名顾问。对于未回复者，通过电话（中级及以上医生级别，或者高级新生儿护士从业者）进行随访。
结果
191个新生儿病房的回复率为100%。2024年，134个（70%）新生儿病房使用了LISA，而2018年为35个（18.7%）病房（p < 0.001）。未进行LISA的原因是缺乏经验/培训（51%）或没有标准化操作/指南（49%）。分娩室（DS）中LISA的使用从2018年的2%增加到2024年的16%，并且用于LISA的视频喉镜的使用正在成为标准操作。在DS和新生儿病房中使用LISA的氧需求标准已降至FiO2为0.3或更高。
结论
在英国，LISA的采用率有所提高。在DS中LISA的使用更为广泛。缺乏培训和专业知识是未进行LISA的主要限制因素。
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