Individual research recommendation details

Recommendation ID

NG124/2

Question

What is the best technique for delivering surfactant in a minimally invasive manner? 

Any explanatory notes
(if applicable)

It is established clinical practice in the UK to give surfactant to preterm babies needing invasive ventilation in the early postnatal period, based on good evidence and extensive clinical experience, so the committee agreed to make a recommendation that reinforces this.

In preterm babies who do not require invasive ventilation, there was evidence that minimally invasive surfactant administration techniques reduce the incidence of BPD, the number of days on invasive ventilation, and the incidence of pneumothorax, compared with endotracheal administration.

However, not all neonatal units have the facilities to carry out minimally invasive surfactant administration techniques, and not all healthcare professionals have been trained to use them. The committee agreed that in these circumstances, endotracheal surfactant administration followed by early extubation should be used, because there was evidence that it reduces the incidence of BPD compared with conventional administration of surfactant with continued ventilation.

Because there was not enough good evidence to make recommendations on which minimally invasive administration technique leads to the best outcomes, or on different surfactant dosing regimens, the committee recommended that further research be done in these areas.

Source guidance details

Comes from guidance

Specialist neonatal respiratory care for babies born preterm

Number

NG124

Date issued

April 2019

Other details