LISA journey and experience at MMUH’s local neonatal unit
This article outlines the provision of less invasive surfactant administration (LISA) at Midland Metropolitan University Hospital’s (MMUH) local neonatal unit. The procedure is associated with a reduction in bronchopulmonary dysplasia and the number of days that an infant is mechanically ventilated, compared to the previous conventional way of administrating surfactant while infants were ventilated or via the INSURE technique.1 The hospital’s LISA guidelines have been revised for a local edition, where pre-medication (sedation) has been replaced by non-pharmacological techniques such as cuddle and wrap, as well as sucrose. Fentanyl might cause respiratory depression and chest wall rigidity, ending with a requirement for positive pressure ventilation and intubation.2 Only approximately 30% of neonatal units in the UK use sedation such as fentanyl or other opioids.3 After the guidelines were approved,4 staff were trained through simulation and the LISA procedure has now become routine.
Dr Ahmed YousefLocum Neonatal Consultant ahmed.yousef3@nhs.net
Dr Khalaf Alkayed
Neonatal registrar
Angelita Rahman
ANNAP
Midland Metropolitan University Hospital, Sandwell and West Birmingham NHS Trust
Yousef A., Alkayed K., Rahman A. LISA journey and experience at MMUH’s local neonatal unit. Infant 2025; 21(5): 136-38.
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- LISA is associated with a reduction in bronchopulmonary dysplasia.
- LISA began at the MMUH in July 2023 and has become a routine procedure.
- LISA is an advanced technique of administering an adequate dose of exogenous surfactant slowly into the lungs without endotracheal intubation.
- LISA technique is performed while the infant is breathing spontaneously and positive end expiratory pressure via nCPAP is maintained.
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