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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| Format: | Article |
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MDPI AG
2025-01-01
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| Series: | Children |
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| 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. |
| format | Article |
| id | doaj-art-36b6a6d9d6d840399cf8dfe157e13e62 |
| institution | DOAJ |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| 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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