{"id":52579,"date":"2026-02-20T10:38:22","date_gmt":"2026-02-20T10:38:22","guid":{"rendered":"https:\/\/campusvygon.com\/uk\/?p=52579"},"modified":"2026-02-19T13:23:31","modified_gmt":"2026-02-19T13:23:31","slug":"translating-evidence-into-practice-a-local-neonatal-units-experience-with-less-invasive-surfactant-administration-lisa","status":"publish","type":"post","link":"https:\/\/campusvygon.com\/uk\/neonatology\/translating-evidence-into-practice-a-local-neonatal-units-experience-with-less-invasive-surfactant-administration-lisa\/","title":{"rendered":"Translating Evidence into Practice: A Local Neonatal Units Experience with Less Invasive Surfactant Administration (LISA)"},"content":{"rendered":"\n<p>Less Invasive Surfactant Administration (LISA) has transformed the respiratory care of preterm infants with respiratory distress syndrome (RDS). It offers a method of delivering life-saving surfactant while avoiding endotracheal intubation and the potential complications associated with mechanical ventilation.<\/p>\n\n\n\n<p>As neonatal units across the UK adopt LISA, local experiences provide valuable insight into the practicalities, challenges, and successes of implementation. This article summarises real\u2011world learning from a neonatal unit that transitioned from traditional surfactant administration to routine use of LISA for spontaneously breathing preterm infants.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><strong>Why LISA?<\/strong><\/h4>\n\n\n\n<p>Surfactant therapy is well established in the management of RDS. Traditionally, surfactant could only be administered via an endotracheal tube, requiring deliberate intubation and often mechanical ventilation \u2014 both of which carry known risks:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>ventilator\u2011induced lung injury<\/li>\n\n\n\n<li>volutrauma\/barotrauma<\/li>\n\n\n\n<li>increased risk of chronic lung disease (CLD)<\/li>\n\n\n\n<li>need for sedation<\/li>\n\n\n\n<li>potential haemodynamic instability<\/li>\n<\/ul>\n\n\n\n<p>LISA aims to reduce or avoid these complications by maintaining the infant\u2019s own breathing effort and delivering surfactant through a thin catheter while the infant remains on continuous positive airway pressure (CPAP).<\/p>\n\n\n\n<p><strong>Key features of LISA include:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Use of a fine, flexible catheter inserted under direct laryngoscopy<\/li>\n\n\n\n<li>No requirement for positive\u2011pressure ventilation<\/li>\n\n\n\n<li>Surfactant delivered in small aliquots while the infant continues to breathe spontaneously<\/li>\n\n\n\n<li>Rapid return to non\u2011invasive support after administration<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"679\" src=\"https:\/\/campusvygon.com\/uk\/wp-content\/uploads\/sites\/9\/2026\/02\/surfactant-administration-2-1024x679.png\" alt=\"\" class=\"wp-image-52584\" style=\"aspect-ratio:1.508133971291866;width:414px;height:auto\" srcset=\"https:\/\/campusvygon.com\/uk\/wp-content\/uploads\/sites\/9\/2026\/02\/surfactant-administration-2-980x650.png 980w, https:\/\/campusvygon.com\/uk\/wp-content\/uploads\/sites\/9\/2026\/02\/surfactant-administration-2-480x318.png 480w\" sizes=\"(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) 1024px, 100vw\" \/><\/figure>\n\n\n\n<p>This approach is designed to be <strong>physiologically gentle<\/strong>, minimising disruption to breathing patterns and reducing the risk of lung injury.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>Implementing LISA: A Local Unit\u2019s Approach<\/strong><\/h3>\n\n\n\n<h6 class=\"wp-block-heading\"><strong>Background<\/strong><\/h6>\n\n\n\n<p>The neonatal team at <em>Ayrshire Maternity Unit<\/em> had already developed strong pathways for early CPAP stabilisation and minimising invasive ventilation. However, they were keen to further reduce intubation rates for preterm infants with RDS. After reviewing published evidence and speaking with neighbouring centres, the team decided to introduce the LISA technique.<\/p>\n\n\n\n<p>The goal was clear:<br><strong>to deliver surfactant more gently, preserve spontaneous breathing, and strengthen the unit\u2019s lung\u2011protective approach.<\/strong><\/p>\n\n\n\n<h6 class=\"wp-block-heading\"><strong>Training and Preparation<\/strong><\/h6>\n\n\n\n<p>Before launching LISA, the Ayrshire team undertook:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Structured training sessions for consultants, ANNPs, and senior nurses<\/li>\n\n\n\n<li>Hands\u2011on workshops focused on catheter placement and laryngoscopy technique<\/li>\n\n\n\n<li>Simulation-based practice, allowing staff to rehearse procedural flow<\/li>\n\n\n\n<li>Development of a local LISA guideline, outlining eligibility, preparation, documentation, and escalation criteria<\/li>\n<\/ul>\n\n\n\n<p>By ensuring multidisciplinary ownership of the pathway, the unit aimed to create confidence and consistency from day one.<\/p>\n\n\n\n<div class=\"wp-block-group is-layout-constrained wp-block-group-is-layout-constrained\">\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:50%\"><\/div>\n<\/div>\n<\/div>\n\n\n\n<h6 class=\"wp-block-heading\"><strong>Early Implementation<\/strong><\/h6>\n\n\n\n<p>In the first months, the team applied LISA to a small number of clinically appropriate infants\u2014typically those:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>&lt;32 weeks<\/li>\n\n\n\n<li>Stable on CPAP but showing increasing work of breathing<\/li>\n\n\n\n<li>Exhibiting FiO\u2082 requirements consistent with early surfactant need<\/li>\n<\/ul>\n\n\n\n<p>Clinicians observed that infants generally tolerated the procedure well, with many maintaining spontaneous breaths throughout surfactant delivery.<\/p>\n\n\n\n<h6 class=\"wp-block-heading\"><strong>Observed Benefits<\/strong><\/h6>\n\n\n\n<p>Several positive trends emerged during the initial implementation phase:<\/p>\n\n\n\n<p><strong>1. Fewer intubations<\/strong><\/p>\n\n\n\n<p>The team saw a reduction in the number of infants requiring mechanical ventilation in the first 72 hours of life.<\/p>\n\n\n\n<p><strong>2. Improved respiratory stability<\/strong><\/p>\n\n\n\n<p>Infants who received LISA often stabilised on lower FiO\u2082 post\u2011procedure, with fewer episodes of desaturation.<\/p>\n\n\n\n<p><strong>3. Smoother transition back to non\u2011invasive support<\/strong><\/p>\n\n\n\n<p>Compared with traditional intubation\u2011surfactant delivery, babies typically resumed CPAP quickly and with less physiological disturbance.<\/p>\n\n\n\n<p><strong>4. Enhanced team confidence<\/strong><\/p>\n\n\n\n<p>Repeated practice and consistent protocol adherence helped staff feel increasingly comfortable with the technique.<\/p>\n\n\n\n<p><strong>5. Positive parental engagement<\/strong><\/p>\n\n\n\n<p>Parents appreciated that the approach was less invasive and aligned with gentle care principles. The team found that discussing LISA early in the neonatal journey helped reduce anxiety and strengthen communication.<\/p>\n\n\n\n<h6 class=\"wp-block-heading\"><strong>Challenges and Lessons Learned<\/strong><\/h6>\n\n\n\n<p>Like many units implementing LISA, Ayrshire Maternity Unit also noted key considerations:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The technique requires good laryngoscopy skills, making experience a crucial factor.<\/li>\n\n\n\n<li>Establishing a clear threshold for surfactant administration helps ensure timely intervention.<\/li>\n\n\n\n<li>Team communication is essential, as LISA works best when roles and responsibilities are pre\u2011defined.<\/li>\n<\/ul>\n\n\n\n<p>Over time, these insights were built into revised guidelines and onboarding materials to maintain high standards.<\/p>\n\n\n\n<h5 class=\"wp-block-heading\"><strong>LISA in the Context of Modern Neonatal Care<\/strong><\/h5>\n\n\n\n<p>The experience at Ayrshire Maternity Unit mirrors the growing trend across the UK towards minimally invasive respiratory support. LISA supports lung\u2011protective strategies and can help:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Reduce chronic lung disease<\/li>\n\n\n\n<li>Minimise invasive procedures<\/li>\n\n\n\n<li>Improve long\u2011term respiratory outcomes<\/li>\n<\/ul>\n\n\n\n<p>As more units adopt LISA, shared learning and consistent training will continue to drive success.<\/p>\n\n\n\n<h6 class=\"wp-block-heading\"><strong>Conclusion<\/strong><\/h6>\n\n\n\n<p>The LISA technique represents a significant advancement in the management of RDS, enabling surfactant administration while preserving spontaneous breathing and reducing the need for mechanical ventilation. The experience of neonatal teams such as those at Ayrshire Maternity Unit demonstrates how effective implementation can enhance outcomes, strengthen respiratory care pathways, and support gentler interventions for preterm infants.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Less Invasive Surfactant Administration (LISA) has transformed the respiratory care of preterm infants with respiratory distress syndrome (RDS). It offers a method of delivering life-saving surfactant while avoiding endotracheal intubation and the potential complications associated with mechanical ventilation. As neonatal units across the UK adopt LISA, local experiences provide valuable insight into the practicalities, challenges, [&hellip;]<\/p>\n","protected":false},"author":141,"featured_media":52589,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[18],"tags":[],"class_list":["post-52579","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-neonatology"],"acf":[],"_links":{"self":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/52579","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/users\/141"}],"replies":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/comments?post=52579"}],"version-history":[{"count":4,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/52579\/revisions"}],"predecessor-version":[{"id":52586,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/52579\/revisions\/52586"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/media\/52589"}],"wp:attachment":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/media?parent=52579"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/categories?post=52579"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/tags?post=52579"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}