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Can Laryngeal Mask Airway be used for surfactant administration in neonates?

Can Laryngeal Mask Airway be used for surfactant administration in neonates?

Roberts and colleagues in a randomized clinical trial examined the feasibility of instilling surfactant non-invasively through and LMA in infnats > 1250g. They found out that surfactant administration by LMA significantly decreased the need for intubation and mechanical ventilation in the first 7 days of life. They reported no serious adverse events including emergent intubations or tension pneumothorax. Post-procedure gastric aspirates revealed 26% had no surfactant aspirated from the stomach, 46% had <10% of the administered dose and 18% had >50% of the administered dose, in the LMA group.

Roberts KD, Brown R, Lampland AL, Leone TA, Rudser KD, Finer NN, et al. Laryngeal mask airway for surfactant administration in neonates: A randomized, controlled trial, J. Pediatr, 2018 Feb; 193; 40-6.

WHY THE BUBBLE CPAP INSTITUTE?
The Bubble CPAP Institute reviews the foundation how bCPAP works. It contains information on the differences between outcomes associated with bCPAP versus endotracheal intubation and mechanical ventilation. In addition, it delineates the difference between bCPAP, traditional CPAP, and nasal cannula with oxygen supplementation. The quality page provides steps on initiating a new bCPAP program in a Neonatal Intensive Care Unit, including preparing the environment for success and ensuring quality and standardization of the process. The Bubble CPAP Institute offers educational materials in various formats that areaccessible via personal computers and mobile devices. Educational modules are presented as written chapters, visual presentations and hands-on descriptive videos. In a later phase, the Bubble CPAP Institute will offer interactive services such as discussion blogs and free consultations with experts for advice on bCPAP assembly and troubleshooting.  

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The Bubble CPAP Institute is an interactive educational platform aiming to make the knowledge and skill set of Bubble CPAP accessible to practitioners who care for neonates and young infants across the globe. This platform will primarily focus on the know-how and will offer educational modules on issues like when to consider bCPAP in managing infants with respiratory distress, how to assemble the bCPAP circuits, how to apply the nasal interface and how to troubleshoot bedside issues.

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