Video laryngoscopy-assisted less-invasive surfactant administration quality improvement initiative.

Objective: To describe the use of quality improvement methodology in transitioning from delivery of surfactant by INSURE (INtubation-SURfactant administration-Extubation) to video laryngoscope-assisted LISA (less-invasive surfactant administration) for infants with respiratory distress syndrome (RDS) receiving non-invasive ventilatory support.

Setting: Two large neonatal intensive care units (NICUs) at Northwell Health (New Hyde Park, New York, USA).

Study Population: Infants with RDS receiving continuous positive airway pressure in the NICU and eligible for surfactant administration.

Unbound bilirubin measurements by a novel probe in preterm infants.

Background: Hyperbilirubinemia occurs in over 80% of newborns and severe bilirubin toxicity can lead to neurological dysfunction and death, especially in preterm infants. Currently, the risk of bilirubin toxicity is assessed by measuring the levels of total serum bilirubin (TSB), which are used to direct treatments including immunoglobulin administration, phototherapy, and exchange transfusion. However, free, unbound bilirubin levels (Bf) predict the risk of bilirubin neurotoxicity more accurately than TSB.