title: Catheter and Laryngeal Mask Endotracheal Surfactant Therapy: the CALMEST approach as a novel MIST technique.
abstract: OBJECTIVE
  Neonatal respiratory distress syndrome (RDS) is a major cause of mortality and morbidity among preterm infants. Although the INSURE (INtubation, SURfactant administration, Estubation) technique for surfactant replacement therapy is so far the gold standard method, over the last years new approaches have been studied, i.e. less invasive surfactant administration (LISA) or minimally invasive surfactant therapy (MIST). Here we propose an originally modified MIST, called CALMEST (Catheter And Laryngeal Mask Endotracheal Surfactant Therapy), using a particular laryngeal mask as a guide for a thin catheter to deliver surfactant directly in the trachea.
  
  
  METHODS
  We performed a preliminary study on a mannequin and a subsequent in vivo pilot trial.
  
  
  CONCLUSIONS
  This novel procedure is quick, effective and well tolerated and might represent an improvement in reducing neonatal stress. Ultimately, CALMEST offers an alternative approach that could be extremely useful for medical staff with low expertise in laryngoscopy and intubation.
authors: a U.O. Neonatologia, Centro di Formazione e Simulazione Neonatale "NINA", Azienda Ospedaliero-Universitaria Pisana , Pisa , Italy.
authors: Ilaria
authors: I
authors: Vannozzi
authors: a U.O. Neonatologia, Centro di Formazione e Simulazione Neonatale "NINA", Azienda Ospedaliero-Universitaria Pisana , Pisa , Italy.
authors: Massimiliano
authors: M
authors: Ciantelli
authors: a U.O. Neonatologia, Centro di Formazione e Simulazione Neonatale "NINA", Azienda Ospedaliero-Universitaria Pisana , Pisa , Italy.
authors: Francesca
authors: F
authors: Moscuzza
authors: a U.O. Neonatologia, Centro di Formazione e Simulazione Neonatale "NINA", Azienda Ospedaliero-Universitaria Pisana , Pisa , Italy.
authors: Rosa T
authors: RT
authors: Scaramuzzo
authors: b Scuola Superiore Sant'Anna, Istituto di Scienze della Vita , Pisa , Italy , and.
authors: Davide
authors: D
authors: Panizza
authors: a U.O. Neonatologia, Centro di Formazione e Simulazione Neonatale "NINA", Azienda Ospedaliero-Universitaria Pisana , Pisa , Italy.
authors: Emilio
authors: E
authors: Sigali
authors: a U.O. Neonatologia, Centro di Formazione e Simulazione Neonatale "NINA", Azienda Ospedaliero-Universitaria Pisana , Pisa , Italy.|c Dipartimento di Medicina Clinica e Sperimentale, Università di Pisa , Italy.
authors: Antonio
authors: A
authors: Boldrini
authors: a U.O. Neonatologia, Centro di Formazione e Simulazione Neonatale "NINA", Azienda Ospedaliero-Universitaria Pisana , Pisa , Italy.
authors: Armando
authors: A
authors: Cuttano
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D017214:Laryngeal Masks; D008297:Male; D010865:Pilot Projects; D011663:Pulmonary Surfactants / Q000008:administration & dosage*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*
chemical_list: D011663:Pulmonary Surfactants
keywords: MIST; N-CPAP; Surfactant; laryngeal mask; respiratory distress