Airway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report

Abstract Background The use of less invasive surfactant administration (LISA)/minimally invasive surfactant therapy (MIST) has increased due to its potential advantage over traditional surfactant delivery methods through an endotracheal tube. Known complications for this procedure include failure of...

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Autores principales:	Talal Altamimi, Brooke Read, Orlando da Silva, Soume Bhattacharya
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Less invasive surfactant administration Minimal invasive surfactant therapy Complications Tracheal perforation Air leak Pneumomediastinum Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/40c21dddf01545c2889b4dbdf0f3369c
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spelling	oai:doaj.org-article:40c21dddf01545c2889b4dbdf0f3369c2021-11-14T12:33:24ZAirway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report10.1186/s12887-021-02981-w1471-2431https://doaj.org/article/40c21dddf01545c2889b4dbdf0f3369c2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12887-021-02981-whttps://doaj.org/toc/1471-2431Abstract Background The use of less invasive surfactant administration (LISA)/minimally invasive surfactant therapy (MIST) has increased due to its potential advantage over traditional surfactant delivery methods through an endotracheal tube. Known complications for this procedure include failure of the first attempt at insertion, desaturation, and bradycardia. To the best of our knowledge, this is the first reported case of pneumomediastinum and subcutaneous emphysema following LISA. Case presentation A preterm newborn born at 27 weeks of gestation presented with respiratory distress syndrome requiring surfactant replacement. LISA using the Hobart method was completed. There was a report of procedural difficulty related to increased resistance to insertion of the 16G angiocath. The newborn was subsequently noted to have subcutaneous emphysema over the anterior aspect of the neck and substantial pneumomediastinum on radiological assessment. Associated complications included hypotension requiring inotropic support. The newborn was successfully managed conservatively, with complete resolution of the air leak. Conclusions Upper airway injury leading to air leak syndrome is a rare complication of the Hobart method for LISA. Awareness of such procedural complications is important as the use of the LISA method increases.Talal AltamimiBrooke ReadOrlando da SilvaSoume BhattacharyaBMCarticleLess invasive surfactant administrationMinimal invasive surfactant therapyComplicationsTracheal perforationAir leakPneumomediastinumPediatricsRJ1-570ENBMC Pediatrics, Vol 21, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Less invasive surfactant administration Minimal invasive surfactant therapy Complications Tracheal perforation Air leak Pneumomediastinum Pediatrics RJ1-570
spellingShingle	Less invasive surfactant administration Minimal invasive surfactant therapy Complications Tracheal perforation Air leak Pneumomediastinum Pediatrics RJ1-570 Talal Altamimi Brooke Read Orlando da Silva Soume Bhattacharya Airway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report
description	Abstract Background The use of less invasive surfactant administration (LISA)/minimally invasive surfactant therapy (MIST) has increased due to its potential advantage over traditional surfactant delivery methods through an endotracheal tube. Known complications for this procedure include failure of the first attempt at insertion, desaturation, and bradycardia. To the best of our knowledge, this is the first reported case of pneumomediastinum and subcutaneous emphysema following LISA. Case presentation A preterm newborn born at 27 weeks of gestation presented with respiratory distress syndrome requiring surfactant replacement. LISA using the Hobart method was completed. There was a report of procedural difficulty related to increased resistance to insertion of the 16G angiocath. The newborn was subsequently noted to have subcutaneous emphysema over the anterior aspect of the neck and substantial pneumomediastinum on radiological assessment. Associated complications included hypotension requiring inotropic support. The newborn was successfully managed conservatively, with complete resolution of the air leak. Conclusions Upper airway injury leading to air leak syndrome is a rare complication of the Hobart method for LISA. Awareness of such procedural complications is important as the use of the LISA method increases.
format	article
author	Talal Altamimi Brooke Read Orlando da Silva Soume Bhattacharya
author_facet	Talal Altamimi Brooke Read Orlando da Silva Soume Bhattacharya
author_sort	Talal Altamimi
title	Airway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report
title_short	Airway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report
title_full	Airway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report
title_fullStr	Airway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report
title_full_unstemmed	Airway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report
title_sort	airway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report
publisher	BMC
publishDate	2021
url	https://doaj.org/article/40c21dddf01545c2889b4dbdf0f3369c
work_keys_str_mv	AT talalaltamimi airwayinjuryandpneumomediastinumassociatedwithlessinvasivesurfactantadministrationinaprematureneonateacasereport AT brookeread airwayinjuryandpneumomediastinumassociatedwithlessinvasivesurfactantadministrationinaprematureneonateacasereport AT orlandodasilva airwayinjuryandpneumomediastinumassociatedwithlessinvasivesurfactantadministrationinaprematureneonateacasereport AT soumebhattacharya airwayinjuryandpneumomediastinumassociatedwithlessinvasivesurfactantadministrationinaprematureneonateacasereport
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Airway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case report

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