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This is an unblinded, randomized, controlled, crossover (AB/BA) trial of surfactant treatment with LISA vs. INSURE in a manikin simulating an extremely low birth weight infant. Participants will be level III NICU consultants and residents. Randomization will be performed using a computer-generated random assignment list. The primary outcome measure will be the total time of device positioning. The secondary outcomes will be the success of the first and the participant's satisfaction.
Background: Although LISA offers some advantages in ventilation procedure and neonatal outcomes over INSURE, the use of a catheter during LISA may have some drawbacks such as the prolonged duration of the laryngoscopy needed to insert the device. This is likely to aggravate the invasiveness of the procedure, resulting in stressful consequences such as bradycardia, hypoxia and hemodynamic changes.
Objectives: i) time of device positioning, ii) success of the procedure of positioning the device, iii) participant's satisfaction.
Methods: This is an unblinded, randomized, controlled, crossover (AB/BA) trial of surfactant treatment with LISA vs. INSURE in a manikin simulating an extremely low birth weight infant. Participants will be level III NICU consultants and residents. Randomization will be performed using a computer-generated random assignment list. The primary outcome measure will be the total time of device positioning. The secondary outcomes will be the success of the first and the participant's satisfaction.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Surfactant administration with less invasive surfactant administration (LISA) approach | Experimental | Participants will be randomized to administer surfactant in a preterm manikin by using the LISA approach (thin catheter) |
|
| Surfactant administration with intubation (INSURE) approach | Active Comparator | Participants will be randomized to administer surfactant in a preterm manikin by using the INSURE approach (tracheal tube) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| LISA approach | Procedure | Participants will be randomized to administer surfactant in a preterm manikin by using the LISA approach (thin catheter) or the INSURE approach (tracheal tube) |
| Measure | Description | Time Frame |
|---|---|---|
| Time of device positioning | Time needed for the correct positioning of the device into the trachea (thin catheter or tracheal tube). In case of failure, total time will be the sum of time of all attempts. | 10 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| Success of the procedure at the first attempt | It refers at the success of the device positioning during the first attempt | 1 minute |
| Participant's satisfaction | At the end of the procedure, all participants will be required to fill a 5-item questionnaire aimed to assess their perception on the procedure (Likert scale) |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Poliambulanza Breacia | Brescia | Italy | ||||
| University Hospital of Padova |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36261132 | Derived | Cavallin F, Bua B, Pasta E, Savio F, Villani PE, Trevisanuto D. Device positioning with LISA vs. INSURE: a crossover randomized controlled manikin trial. J Matern Fetal Neonatal Med. 2022 Dec;35(26):10577-10583. doi: 10.1080/14767058.2022.2134774. Epub 2022 Oct 19. |
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| ID | Term |
|---|---|
| D012128 | Respiratory Distress Syndrome |
| D047928 | Premature Birth |
| D001261 | Pulmonary Atelectasis |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012120 | Respiration Disorders |
| D007752 | Obstetric Labor, Premature |
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|
| Insure approach | Procedure | Participants will be randomized to administer surfactant in a preterm manikin by using the INSURE approach (tracheal tube) |
|
| 5 minutes |
| Number of attempts to insert the device in the trachea | It refers to the number of attempts to insert the device in the trachea | 10 minutes |
| Correct depth of the device in the trachea | It refers to reaching the correct depth in the trachea as assessed by the external observer using a laryngoscope | 10 minutes |
| Padova |
| 35128 |
| Italy |
| D007744 | Obstetric Labor Complications |
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |