SynthesisEuropean journal of pediatrics2016
Surfactant instillation in spontaneously breathing preterm infants: a systematic review and meta-analysis.
Synthesis in European journal of pediatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 40 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Application of Modified Intubation-surfactant-extubation (InSurE) Technique in Preterm Neonates With Respiratory Distress Syndrome
Use of Premedication for Less Invasive Surfactant Administration: A Randomized Control Trial
Who cites it
40 citing papers in PubMed, 4 syntheses or guidelines pooled it, 99 citations in OpenAlex.
- Overview of the Effectiveness of Different Surfactant Administration Methods: An Umbrella Review of Meta-Analyses.Pediatric pulmonology · 2026Pooled it
- Less Invasive Surfactant Administration Compared to Intubation, Surfactant, Rapid Extubation Method in Preterm Neonates: An Umbrella Review.Neonatology · 2024Pooled it
- Sedation for less invasive surfactant administration in preterm infants: a systematic review and meta-analysis.Pediatric research · 2023Pooled it
- Sustained inflations and avoiding mechanical ventilation to prevent death or bronchopulmonary dysplasia: a meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2018Pooled it
- Comparing the Effects of Two Surfactant Administration Methods: Minimally Invasive Surfactant Therapy (MIST) with Intubation (INSURE) in Infants with Respiratory Distress Syndrome.Advances in respiratory medicine · 2024Trial
- Minimally invasive surfactant therapy outcomes in infants born at 28-37 weeks' gestation.Journal of perinatology : official journal of the California Perinatal Association · 2026Article
- Less invasive surfactant administration versus intubation-surfactant-extubation: a single-center retrospective study.Clinical and experimental pediatrics · 2025Article
- Comparison of Minimally Invasive Surfactant Therapy and Intubation-surfactant Administration-extubation in Premature Neonates with Respiratory Distress Syndrome.Oman medical journal · 2025Article
- A sustained reduction in the rate of severe intraventricular hemorrhage in very low birth weight infants: a novel quality improvement project in a large perinatal-neonatal centre in Asia.Frontiers in pediatrics · 2025Article
- Prevention of Chronic Morbidities in Extremely Premature Newborns with LISA-nCPAP Respiratory Therapy and Adjuvant Perinatal Strategies.Antioxidants (Basel, Switzerland) · 2023Review
- Perinatal origins of bronchopulmonary dysplasia-deciphering normal and impaired lung development cell by cell.Molecular and cellular pediatrics · 2023Review
- Should less invasive surfactant administration (LISA) become routine practice in US neonatal units?Pediatric research · 2023Review
- Less Invasive Surfactant Administration: A Review of Current Evidence of Clinical Outcomes With Beractant.Cureus · 2022Review
- Incidence, predictors of success and outcome of LISA in very preterm infants.Pediatric pulmonology · 2022Article
- Poractant alfa versus bovine lipid extract surfactant: prospective comparative effectiveness study.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Health Economics of Selective Early Rescue Surfactant Administration and Standard Surfactant Administration for Newborns With Respiratory Distress Syndrome.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022Article
- Improved Less Invasive Surfactant Administration Success in Preterm Infants after Procedure Standardization.Children (Basel, Switzerland) · 2021Article
- Alternative Methods of Surfactant Administration in Preterm Infants with Respiratory Distress Syndrome: State of the Art.Turkish archives of pediatrics · 2021Article
- Stimulating and maintaining spontaneous breathing during transition of preterm infants.Pediatric research · 2021Review
- Introducing Less-Invasive Surfactant Administration into a Level IV NICU: A Quality Improvement Initiative.Children (Basel, Switzerland) · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Less invasive surfactant therapies (LIST) use surfactant instillation through a thin tracheal catheter in spontaneously breathing infants. This review and meta-analysis investigates respiratory outcomes for preterm infants with respiratory distress syndrome treated with LIST rather than administration of surfactant through an endotracheal tube. Randomised controlled trial (RCT) full texts provided outcome data for bronchopulmonary dysplasia (BPD), death or BPD, early CPAP failure, invasive ventilation requirements and usual neonatal morbidities. Relative risks (RR) from pooled data, with subgroup analyses, were obtained from a Mantel-Haenszel analysis using a random effect model. Six RCTs evaluated LIST: 4 vs InSurE and 1 each vs delayed or immediate intubation for surfactant. LIST resulted in decreased risks of BPD (RR = 0.71 [0.52-0.99]; NNT = 21), death or BPD (RR = 0.74 [0.58-0.94]; NNT = 15) and early CPAP failure or invasive ventilation requirements (RR = 0.67 [0.53-0.84]; NNT = 8 and RR = 0.69 [0.53-0.88]; NNT = 6). Compared to InSurE, LIST decreased the risks of BPD or death (RR = 0.63 [0.44-0.92]; NNT = 11) and of early CPAP failure (RR = 0.71 [0.53-0.96]; NNT = 11). Common neonatal morbidities were not different.
conclusionsRespiratory management with LIST decreases the risks of BPD and BPD or death, and the need for invasive ventilation. This strategy appears safe, but long-term follow-up is lacking. What is Known: • Initial management of preterm infants with CPAP decreases the risk of death or BPD, but many still require surfactant or invasive ventilation. • Surfactant can be instilled through a tracheal thin catheter while the infant breathes on CPAP, but improvement in BPD is inconsistent between studies. What is New: • Less invasive surfactant therapy (LIST) strategies decrease the risks of BPD, of death or BPD, and of CPAP failure compared to strategies where surfactant is administered through an endotracheal tube. • LIST strategies decrease the risks of the composite outcome of BPD or death and of early CPAP failure when compared to "intubation-surfactant-extubation" approaches.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.