Minimally invasive surfactant administration in extremely preterm infants <28 weeks gestation with spontaneous breathing: a retrospective quality improvement study on reducing invasive ventilation burden.

Wenxin Dong, Hui Zhang, Xinyue Li, Hua Zhang, Zailing Li, Tongyan Han

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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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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Wenxin Dong *Department of Pediatrics, Peking University Third Hospital, Beijing, China.

Hui Zhang *Department of Pediatrics, Peking University Third Hospital, Beijing, China.

Xinyue LiDepartment of Pediatrics, Peking University Third Hospital, Beijing, China.

Hua ZhangResearch Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.

Zailing LiDepartment of Pediatrics, Peking University Third Hospital, Beijing, China.

Tongyan HanDepartment of Pediatrics, Peking University Third Hospital, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

extremely preterm infantsinvasive mechanical ventilationminimally invasive surfactant administrationpatent ductus arteriosusquality improvementrespiratory distress syndrome

Identifiers

PMID41918700

DOI10.3389/fped.2026.1780241

PMCPMC13033681

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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.