Laryngeal Mask Airway Method for Minimally Invasive Surfactant Therapy in Neonates with Pneumothorax Complicating Respiratory Distress Syndrome

Background/Objectives: Pneumothorax is a common complication of neonatal respiratory distress syndrome, which is decreased by surfactant therapy. Rescue administration of surfactant in neonates with severe RDS complicated by pneumothorax requires management of the pneumothorax to optimize surfactant...

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Main Authors: Joaquim M. B. Pinheiro, Marilyn Fisher, Kate A. Tauber, Chad Pezzano
Format: Article
Language:English
Published: MDPI AG 2025-01-01
Series:Children
Subjects:
Online Access:https://www.mdpi.com/2227-9067/12/2/134
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author Joaquim M. B. Pinheiro
Marilyn Fisher
Kate A. Tauber
Chad Pezzano
author_facet Joaquim M. B. Pinheiro
Marilyn Fisher
Kate A. Tauber
Chad Pezzano
author_sort Joaquim M. B. Pinheiro
collection DOAJ
description Background/Objectives: Pneumothorax is a common complication of neonatal respiratory distress syndrome, which is decreased by surfactant therapy. Rescue administration of surfactant in neonates with severe RDS complicated by pneumothorax requires management of the pneumothorax to optimize surfactant distribution while avoiding positive pressure ventilation to minimize iatrogenic exacerbation of the air leak. Methods: We retrospectively reviewed our center’s experience with neonates who had clinically significant pneumothorax complicating RDS, in whom we used a novel technique to administer surfactant through a laryngeal mask/supraglottic airway device without applying positive pressure ventilation. Results: In 13 of the 20 neonates in our cohort, subsequent invasive ventilation and chest tube insertion were avoided. There were no major complications or unfavorable outcomes. We describe our experience with this method and suggest an approach to individualize the management of neonates with pneumothorax preceding surfactant therapy. Conclusions: In our setting, laryngeal mask airway devices are now the preferred method to deliver surfactant in neonates with RDS and pre-existing pneumothorax. We believe this approach is readily applicable in most neonatal care settings.
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spelling doaj-art-36b6a6d9d6d840399cf8dfe157e13e622025-08-20T03:12:08ZengMDPI AGChildren2227-90672025-01-0112213410.3390/children12020134Laryngeal Mask Airway Method for Minimally Invasive Surfactant Therapy in Neonates with Pneumothorax Complicating Respiratory Distress SyndromeJoaquim M. B. Pinheiro0Marilyn Fisher1Kate A. Tauber2Chad Pezzano3Division of Neonatology, Department of Pediatrics, Albany Medical College, Albany, NY 12208, USADivision of Neonatology, Department of Pediatrics, Albany Medical College, Albany, NY 12208, USADivision of Neonatology, Department of Pediatrics, Albany Medical College, Albany, NY 12208, USADivision of Neonatology, Department of Pediatrics, Albany Medical College, Albany, NY 12208, USABackground/Objectives: Pneumothorax is a common complication of neonatal respiratory distress syndrome, which is decreased by surfactant therapy. Rescue administration of surfactant in neonates with severe RDS complicated by pneumothorax requires management of the pneumothorax to optimize surfactant distribution while avoiding positive pressure ventilation to minimize iatrogenic exacerbation of the air leak. Methods: We retrospectively reviewed our center’s experience with neonates who had clinically significant pneumothorax complicating RDS, in whom we used a novel technique to administer surfactant through a laryngeal mask/supraglottic airway device without applying positive pressure ventilation. Results: In 13 of the 20 neonates in our cohort, subsequent invasive ventilation and chest tube insertion were avoided. There were no major complications or unfavorable outcomes. We describe our experience with this method and suggest an approach to individualize the management of neonates with pneumothorax preceding surfactant therapy. Conclusions: In our setting, laryngeal mask airway devices are now the preferred method to deliver surfactant in neonates with RDS and pre-existing pneumothorax. We believe this approach is readily applicable in most neonatal care settings.https://www.mdpi.com/2227-9067/12/2/134neonatespneumothoraxrespiratory distress syndromesurfactant therapylaryngeal mask airwaysupraglottic airway devices
spellingShingle Joaquim M. B. Pinheiro
Marilyn Fisher
Kate A. Tauber
Chad Pezzano
Laryngeal Mask Airway Method for Minimally Invasive Surfactant Therapy in Neonates with Pneumothorax Complicating Respiratory Distress Syndrome
Children
neonates
pneumothorax
respiratory distress syndrome
surfactant therapy
laryngeal mask airway
supraglottic airway devices
title Laryngeal Mask Airway Method for Minimally Invasive Surfactant Therapy in Neonates with Pneumothorax Complicating Respiratory Distress Syndrome
title_full Laryngeal Mask Airway Method for Minimally Invasive Surfactant Therapy in Neonates with Pneumothorax Complicating Respiratory Distress Syndrome
title_fullStr Laryngeal Mask Airway Method for Minimally Invasive Surfactant Therapy in Neonates with Pneumothorax Complicating Respiratory Distress Syndrome
title_full_unstemmed Laryngeal Mask Airway Method for Minimally Invasive Surfactant Therapy in Neonates with Pneumothorax Complicating Respiratory Distress Syndrome
title_short Laryngeal Mask Airway Method for Minimally Invasive Surfactant Therapy in Neonates with Pneumothorax Complicating Respiratory Distress Syndrome
title_sort laryngeal mask airway method for minimally invasive surfactant therapy in neonates with pneumothorax complicating respiratory distress syndrome
topic neonates
pneumothorax
respiratory distress syndrome
surfactant therapy
laryngeal mask airway
supraglottic airway devices
url https://www.mdpi.com/2227-9067/12/2/134
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AT marilynfisher laryngealmaskairwaymethodforminimallyinvasivesurfactanttherapyinneonateswithpneumothoraxcomplicatingrespiratorydistresssyndrome
AT kateatauber laryngealmaskairwaymethodforminimallyinvasivesurfactanttherapyinneonateswithpneumothoraxcomplicatingrespiratorydistresssyndrome
AT chadpezzano laryngealmaskairwaymethodforminimallyinvasivesurfactanttherapyinneonateswithpneumothoraxcomplicatingrespiratorydistresssyndrome