ArticlePloS one2020
Implementation of less invasive surfactant administration in clinical practice-Experience of a mid-sized country.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Safety of Less Invasive Surfactant Administration in Preterm Infants: A Meta-Analysis.Pediatric pulmonology · 2026Pooled it
- Sedation for less invasive surfactant administration in preterm infants: a systematic review and meta-analysis.Pediatric research · 2023Pooled it
- Nasal Continuous Positive Airway Pressure vs Nasal Intermittent Positive Pressure Ventilation in Preterm Infants With Respiratory Distress Syndrome: A Randomized Clinical Trial.JAMA network open · 2026Trial
- Clinical Outcomes and Hospitalization Cost of Minimally Invasive Surfactant Therapy vs. INSURE (Intubate-Surfactant-Extubate) Method in Neonates with Respiratory Distress Syndrome.Indian journal of pediatrics · 2026Article
- Pulmonary comorbidities and response to surfactant in late preterm infants: a multicenter cohort study.Pediatric research · 2026Observational
- Assessing competency in less invasive surfactant administration: simulation-based validity evidence for the LISA-AT scores.Pediatric research · 2025Article
- Curriculum and assessment tool for less invasive surfactant administration: an international Delphi consensus study.Pediatric research · 2023Article
- Prevention of Chronic Morbidities in Extremely Premature Newborns with LISA-nCPAP Respiratory Therapy and Adjuvant Perinatal Strategies.Antioxidants (Basel, Switzerland) · 2023Review
- Clinical impact of less invasive surfactant administration using video laryngoscopy in extremely preterm infants.Pediatric research · 2023Article
- Purpose Built Catheters for Minimally Invasive Surfactant Therapy: Experience from a Canadian Tertiary Level Neonatal Intensive Care Unit.Canadian journal of respiratory therapy : CJRT = Revue canadienne de la therapie respiratoire : RCTR · 2023Article
- Effects of less invasive surfactant administration versus intubation-surfactant-extubation on bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome: a single-center, retrospective study from China.BMC pulmonary medicine · 2022Article
- 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
- Article
- 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
- FiOFrontiers in pediatrics · 2021Article
- Dose Effect of Poractant Alfa in Neonatal RDS: Analysis of Combined Data from Three Prospective Studies.Frontiers in pediatrics · 2020Article
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThere are differences in the adoption rates of less invasive surfactant administration (LISA) worldwide. We aimed to describe and analyze the process of LISA introduction at the country level.
methodsA standardized training program (33 courses covering >500 neonatologists) was followed by a cohort study. Data regarding consecutive LISA procedures were acquired over 12 months in 31 tertiary neonatal centers, using a dedicated on-line platform.
resultsOf 500 LISA procedures, 75% were performed by specialists and 25% by residents. The mean percentage share of LISA in all surfactant therapies was 24%, which represents a 6-fold increase compared to previous years. After 12 months, 76% of the procedures were rated "easy/very easy" vs 59% at baseline (p<0.05). Surfactant re-treatment rate was 15%. Twenty-three percent of infants required mechanical ventilation within 72 hours of life. Oxygen desaturation and surfactant reflux were the most frequent complications. Unlike previous reports describing exclusive use of nasal continuous positive airway pressure (nCPAP) during LISA, majority of procedures (63%) were carried out using nasal intermittent positive pressure ventilation (NIPPV) or Bilevel Positive Airway Pressure (BiPAP). Efficacy of LISA with NIPPV or BiPAP was not significantly different from that with nCPAP (22.4% vs 24.5% of cases requiring intubation). Ventilation was provided with nasal cannulas or nasal masks (90%) and rarely with "RAM" cannulas or nasopharyngeal tubes. Rigid catheters were preferred (88.4%); tracheal insertion was successful at first attempt in 87% of cases. Majority of infants (79%) received no premedication prior to the procedure and almost all were given caffeine citrate. Median time of instillation was 1.5 minutes.
conclusionsThe LISA procedure does not appear to be technically difficult to master. Training combining theory with practical exercises is an efficient implementation strategy. Variations in adoption rates indicate the need for additional, more personalized teachings in some centers.
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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.