Evidence map›Paper›PMID 42606389›Full record

SynthesisPediatric pulmonology2026

Overview of the Effectiveness of Different Surfactant Administration Methods: An Umbrella Review of Meta-Analyses.

Anita Hartikainen, Panu Kiviranta, Kati Räsänen, Ilari Kuitunen

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Pediatric pulmonology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Anita HartikainenKuopio Pediatric Research Unit, University of Eastern Finland, Kuopio, Finland.
Panu KivirantaDepartment of Pediatrics and Neonatology, Kuopio University Hospital, Kuopio, Finland.
Kati RäsänenKuopio Pediatric Research Unit, University of Eastern Finland, Kuopio, Finland.
Ilari KuitunenKuopio Pediatric Research Unit, University of Eastern Finland, Kuopio, Finland.ORCID https://orcid.org/0000-0001-8178-9610

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the effectiveness of various surfactant administration methods.

methodsWe conducted an umbrella review of meta-analyses conducted on randomized controlled trials. The search was conducted in March 2024 in four databases. Two authors screened the results and extracted the data. Review quality was assessed according to AMSTAR-2. Traffic-light plots were used to summarize the effectiveness of different administration methods.

resultsNineteen meta-analyses comprising 247 comparisons were included. The most evaluated method was less invasive surfactant administration (LISA), across 16 comparisons versus InSurE and intubation. LISA significantly reduced risks of bronchopulmonary dysplasia (BPD), BPD or death combined, mechanical ventilation, pneumothorax/air leaks, and intraventricular hemorrhage (IVH) versus intubation; it also lowered mortality versus InSurE and intubation. No IVH difference was seen between LISA and InSurE. Five comparisons (17 outcomes) assessed laryngeal mask airway (LMA) against intubation and InSurE. LMA reduced subsequent intubation or mechanical ventilation versus intubation. Findings on post-surfactant FiO

conclusionBased on recent meta-analyses, LISA appears to be the most effective and extensively evaluated surfactant administration method in head-to-head comparisons. Future research should clarify LMA's role and establish a definitive method hierarchy; currently, LISA remains the preferred choice when feasible.

Indexed as

Pulmonary SurfactantsRespiratory Distress Syndrome, NewbornBronchopulmonary DysplasiaHumansInfant, NewbornIntubation, IntratrachealMeta-Analysis as TopicPneumothoraxRandomized Controlled Trials as TopicRespiration, ArtificialTreatment OutcomePulmonary Surfactantsrespiratory distress syndromesurfactantventilation

Identifiers

PMID42606389
PMCPMC13480149

What OpenQuestion holds

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Registered trials

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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.