LISA/MIST技术与早产儿呼吸系统疾病的预后

Less invasive surfactant administration (LISA)/minimally invasive surfactant treatment (MIST) and prognosis of respiratory diseases in premature

经细管肺表面活性物质注入技术[(less invasive surfactant administration,LISA)/(minimally invasive surfactant treatment,MIST)]是肺表面活性物质运用技术的创新,该技术以细管替代气管插管,通过患儿有效自主呼吸,完成外源性肺表面活性物质替代治疗。该技术降低气管插管对气管黏膜损伤的风险,避免了肺表面活性物质运用过程中正压通气过程。因此,该技术可视为早产儿肺保护策略的一部分。相关meta分析结果提示:LISA/MIST技术可减少早产儿机械通气时间,降低早产儿死亡率、36周支气管肺发育不良(BPD)发生率。然而,该技术的细节操作流程并不十分统一,需要继续完善和标准化。研究目的明确、设计合理的多中心临床研究值得期待。

Less invasive surfactant administration（LISA）/minimally invasive surfactant treatment（MIST）is a novel technique of surfactant replacement for neonatal respiratory distress syndrome. With LISA/MIST technique,surfactant is injected into the trachea through a thin tube and the distribution of surfactant mainly depends on infant＇s spontaneous breath.LISA/MIST technique causes less injury to tracheal mucosa and less exposure to positive ventilation in the infants. Therefore,LISA/MIST technique is considered one of the strategies of lung protection in premature infants. Recently meta-analysis has showed LISA/MIST results in less mechanical ventilation time in premature infants with RDS and reduces the composite incidence of death or BPD at corrected gestational age of 36 weeks. However,the procedure of LISA/MIST varies from site to site. Well-designed multicenter clinical researches of LISA/MIST by experienced professionals with standardized procedure are highly expected before a widespread implementation of the technique.