ArticleFrontiers in pediatrics2026
Minimally invasive surfactant administration in extremely preterm infants <28 weeks gestation with spontaneous breathing: a retrospective quality improvement study on reducing invasive ventilation burden.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Invasive surfactant delivery via endotracheal intubation increases exposure to invasive mechanical ventilation (IMV) in extremely preterm infants (EPIs, <28 weeks). This quality improvement (QI) initiative aimed to evaluate whether minimally invasive surfactant administration (MISA) was associated with a reduced IMV burden in EPIs. Methods: A single-center retrospective QI study (2013-2024) included 115 infants (24-27⁺⁶ weeks) with spontaneous breathing diagnosed with respiratory distress syndrome (RDS). Controls (2013-2019, Results: Baseline infant characteristics were comparable. The median duration of IMV within the first 72 h after birth was 0 h (IQR: 0-0) in the MISA group compared to 71.0 h (IQR: 19.0-72.0) in the control group ( Conclusion: MISA was associated with reduced early and overall IMV exposure in EPIs <28 weeks, and with lower observed incidences of hsPDA and nosocomial pneumonia. These associations warrant confirmation in prospective multicenter studies.
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