{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T07:51:22Z","timestamp":1791532282493,"version":"4.3.4"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA"],"published-print":{"date-parts":[[2023,9,19]]},"abstract":"Importance<\/jats:title>The long-term effects of surfactant administration via a thin catheter (minimally invasive surfactant therapy [MIST]) in preterm infants with respiratory distress syndrome remain to be definitively clarified.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine the effect of MIST on death or neurodevelopmental disability (NDD) at 2 years\u2019 corrected age.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>Follow-up study of a randomized clinical trial with blinding of clinicians and outcome assessors conducted in 33 tertiary-level neonatal intensive care units in 11 countries. The trial included 486 infants with a gestational age of 25 to 28 weeks supported with continuous positive airway pressure (CPAP). Collection of follow-up data at 2 years\u2019 corrected age was completed on December 9, 2022.<\/jats:p><\/jats:sec>Interventions<\/jats:title>Infants assigned to MIST (n\u2009=\u2009242) received exogenous surfactant (200 mg\/kg poractant alfa) via a thin catheter; those assigned to the control group (n\u2009=\u2009244) received sham treatment.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The key secondary outcome of death or moderate to severe NDD was assessed at 2 years\u2019 corrected age. Other secondary outcomes included components of this composite outcome, as well as hospitalizations for respiratory illness and parent-reported wheezing or breathing difficulty in the first 2 years.<\/jats:p><\/jats:sec>Results<\/jats:title>Among the 486 infants randomized, 453 had follow-up data available (median gestation, 27.3 weeks; 228 females [50.3%]); data on the key secondary outcome were available in 434 infants. Death or NDD occurred in 78 infants (36.3%) in the MIST group and 79 (36.1%) in the control group (risk difference, 0% [95% CI, \u22127.6% to 7.7%]; relative risk [RR], 1.0 [95% CI, 0.81-1.24]); components of this outcome did not differ significantly between groups. Secondary respiratory outcomes favored the MIST group. Hospitalization with respiratory illness occurred in 49 infants (25.1%) in the MIST group vs 78 (38.2%) in the control group (RR, 0.66 [95% CI, 0.54-0.81]) and parent-reported wheezing or breathing difficulty in 73 (40.6%) vs 104 (53.6%), respectively (RR, 0.76 [95% CI, 0.63-0.90]).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this follow-up study of a randomized clinical trial of preterm infants with respiratory distress syndrome supported with CPAP, MIST compared with sham treatment did not reduce the incidence of death or NDD by 2 years of age. However, infants who received MIST had lower rates of adverse respiratory outcomes during their first 2 years of life.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>anzctr.org.au Identifier: ACTRN12611000916943<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jama.2023.15694","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T15:00:47Z","timestamp":1694444447000},"page":"1054","source":"Crossref","is-referenced-by-count":31,"title":["Two-Year Outcomes After Minimally Invasive Surfactant Therapy in Preterm Infants"],"prefix":"10.1001","volume":"330","author":[{"given":"Peter A.","family":"Dargaville","sequence":"first","affiliation":[{"name":"Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia"},{"name":"Department of Paediatrics, Royal Hobart Hospital, Hobart, Tasmania, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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