Outcomes, safety and health economics of introduction of video laryngoscopy-assisted less invasive surfactant administration

Venkata Gupta; Barry Weinberger; Stephanie G Galanti; Jimikumar Patel; Gangajal Kasniya; Dalibor Kurepa

doi:10.1038/s41372-024-02162-4

Outcomes, safety and health economics of introduction of video laryngoscopy-assisted less invasive surfactant administration

J Perinatol. 2024 Nov 22. doi: 10.1038/s41372-024-02162-4. Online ahead of print.

Authors

Venkata Gupta¹, Barry Weinberger¹, Stephanie G Galanti¹, Jimikumar Patel¹, Gangajal Kasniya², Dalibor Kurepa³

Affiliations

¹ Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Cohen Children's Medical Center, Northwell Health, New Hyde Park, NY, USA.
² Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Ochsner Children's Hospital, Ochsner Health, New Orleans, LA, USA.
³ Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Cohen Children's Medical Center, Northwell Health, New Hyde Park, NY, USA. dkurepa@northwell.edu.

PMID: 39578512
DOI: 10.1038/s41372-024-02162-4

Abstract

Background: Less invasive surfactant administration (LISA) is associated with better outcomes than InSurE (Intubation-Surfactant administration-Extubation). Video-laryngoscopy (VL) facilitates intubation in neonates, however safety and cost-effectiveness of VL-assisted LISA have not been evaluated.

Methods: We compared the outcomes of infants receiving VL-assisted LISA (n = 67) with a historical cohort of infants who received InSurE (n = 52). Secondary aims were to evaluate safety and cost-effectiveness.

Results: VL-assisted LISA was associated with reduced duration of non-invasive ventilation (NIV), reduced duration of oxygen therapy, reduced composite days on NIV and mechanical ventilation (MV), and shorter NICU stay with lower hospital costs for infants ≥29 weeks GA, compared to InSurE. In the VL-assisted LISA group, 66% of the tracheal catheters were placed on the first attempt and 16% of infants displayed desaturation during placement.

Conclusion: In infants ≥29 weeks GA, VL-assisted LISA reduced exposure to NIV, oxygen, NIV and MV combined, length of stay, and cost of care compared to InSurE.