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...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-11-01
|
| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-021-02981-w |
| _version_ | 1818838385633001472 |
|---|---|
| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-19T03:37:34Z |
| format | Article |
| id | doaj.art-40c21dddf01545c2889b4dbdf0f3369c |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-19T03:37:34Z |
| publishDate | 2021-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-40c21dddf01545c2889b4dbdf0f3369c2022-12-21T20:37:20ZengBMCBMC Pediatrics1471-24312021-11-012111610.1186/s12887-021-02981-wAirway injury and pneumomediastinum associated with less invasive surfactant administration in a premature neonate: a case reportTalal Altamimi0Brooke Read1Orlando da Silva2Soume Bhattacharya3Neonatal - Perinatal Medicine, University of WesternNeonatal - Perinatal Medicine, University of WesternNeonatal - Perinatal Medicine, University of WesternNeonatal - Perinatal Medicine, University of WesternAbstract 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.https://doi.org/10.1186/s12887-021-02981-wLess invasive surfactant administrationMinimal invasive surfactant therapyComplicationsTracheal perforationAir leakPneumomediastinum |
| spellingShingle | 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 BMC Pediatrics Less invasive surfactant administration Minimal invasive surfactant therapy Complications Tracheal perforation Air leak Pneumomediastinum |
| title | 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_short | 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 |
| topic | Less invasive surfactant administration Minimal invasive surfactant therapy Complications Tracheal perforation Air leak Pneumomediastinum |
| url | https://doi.org/10.1186/s12887-021-02981-w |
| work_keys_str_mv | AT talalaltamimi airwayinjuryandpneumomediastinumassociatedwithlessinvasivesurfactantadministrationinaprematureneonateacasereport AT brookeread airwayinjuryandpneumomediastinumassociatedwithlessinvasivesurfactantadministrationinaprematureneonateacasereport AT orlandodasilva airwayinjuryandpneumomediastinumassociatedwithlessinvasivesurfactantadministrationinaprematureneonateacasereport AT soumebhattacharya airwayinjuryandpneumomediastinumassociatedwithlessinvasivesurfactantadministrationinaprematureneonateacasereport |