title: Laryngeal mask airway used as a delivery conduit for the administration of surfactant to preterm infants with respiratory distress syndrome.
abstract: BACKGROUND
  The laryngeal mask airway (LMA(TM), Laryngeal Mask Co. Ltd, Jersey, UK) is a supraglottic device used to administer positive pressure ventilation (PPV) in adults, pediatric and neonatal patients.
  
  
  OBJECTIVE
  To avoid endotracheal intubation, we evaluated the feasibility and practicality of administering surfactant via the LMA(TM) in preterm infants with respiratory distress syndrome (RDS).
  
  
  METHODS
  Infants less than 72 h old with a gestational age of < or =35 weeks and a birth weight of >800 g, treated with nasal continuous positive airway pressure (CPAP, 5 cm H2O) for RDS were eligible for inclusion in the study if the arterial-to-alveolar oxygen tension ratio (a/APO2) was <0.20 over a period of >60 min.
  
  
  RESULTS
  Eight preterm infants, median gestational age 31 (range 28-35) weeks; birth weight 1,700 (880-2,520) g, treated with nasal CPAP for RDS were enrolled. Three hours after surfactant instillation, the mean a/APO2 was significantly increased (0.13 +/- 0.04 to 0.34 +/- 0.11; p < 0.01) without complications.
  
  
  CONCLUSIONS
  The LMA may be a useful and noninvasive conduit for the administration of surfactant therapy. A large randomized comparative clinical trial will be required to confirm the efficacy of this technique.
authors.affiliation: Department of Pediatrics, School of Medicine, Padua University, Padua, Italy. trevo@pediatria.unipd.it
authors.forename: Daniele
authors.initials: D
authors.lastname: Trevisanuto
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Grazzina
authors.forename: Paola
authors.initials: P
authors.lastname: Ferrarese
authors.forename: Massimo
authors.initials: M
authors.lastname: Micaglio
authors.forename: Chandy
authors.initials: C
authors.lastname: Verghese
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Zanardo
mesh_terms: D001688:Biological Products / Q000008:administration & dosage*; D001784:Blood Gas Analysis; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood / Q000502:physiology*; D017214:Laryngeal Masks; D008297:Male; D010743:Phospholipids / Q000008:administration & dosage*; D011663:Pulmonary Surfactants / Q000008:administration & dosage*; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood / Q000188:drug therapy*
chemical_list: D001688:Biological Products; D010743:Phospholipids; D011663:Pulmonary Surfactants; C068291:poractant alfa