{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:14:05Z","timestamp":1788261245270,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T00:00:00Z","timestamp":1755129600000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Pulmonology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In October 2018, a respiratory care protocol (RCP) including less invasive surfactant administration (LISA), was introduced for preterm infants admitted on continuous positive airway pressure (CPAP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>We compared respiratory care practices and outcomes of \u2265\u200935\u2010week gestational age (GA) infants between a pre\u2010RCP (Jan 2016 to September 2018) and a post\u2010RCP cohort (Oct 2018 to Dec 2021). Infants requiring &lt;\u200924\u2009h of CPAP and diagnosed with meconium aspiration syndrome were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 260 infants meeting inclusion criteria, 126 belonged to the pre\u2010RCP and 134 to post\u2010RCP cohort. Compared to pre\u2010RCP, a lower proportion of infants in the post\u2010RCP received CPAP on admission but a higher proportion received surfactant therapy (8% vs 22%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Notably, surfactant therapy was associated with lower FiO\n                      <jats:sub>2<\/jats:sub>\n                      requirement for 24\u2009h and respiratory severity score for 48\u2009h in the post\u2010RCP cohort. However, there was no difference in any of the outcomes such as the need for mechanical ventilation, incidence of pneumothorax and length of hospital stay between two cohorts.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementing an RCP increased surfactant use with associated improvement in oxygenation but did not improve outcomes. Further studies are necessary to evaluate the role of LISA in \u2265\u200935\u2010week GA infants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71257","type":"journal-article","created":{"date-parts":[[2025,8,14]],"date-time":"2025-08-14T17:21:32Z","timestamp":1755192092000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness of A Respiratory Care Protocol Including Less Invasive Surfactant Administration in \u2265\u200935 Weeks Gestational Age Infants"],"prefix":"10.1002","volume":"60","author":[{"given":"Etze","family":"Chotzoglou","sequence":"first","affiliation":[{"name":"Division of Neonatal\u2010Perinatal Medicine, Department of Pediatrics University of Texas Southwestern Medical Center Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2804-9311","authenticated-orcid":false,"given":"Arun","family":"Prasath","sequence":"additional","affiliation":[{"name":"Division of Neonatal\u2010Perinatal Medicine, Department of Pediatrics University of Texas Southwestern Medical Center Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riddhi","family":"Desai","sequence":"additional","affiliation":[{"name":"Division of Neonatal\u2010Perinatal Medicine, Department of Pediatrics University of Texas Southwestern Medical Center Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lebanon","family":"David","sequence":"additional","affiliation":[{"name":"Parkland Health and Hospital System Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Ornelas","sequence":"additional","affiliation":[{"name":"Parkland Health and Hospital System Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patti","family":"Burchfield","sequence":"additional","affiliation":[{"name":"Division of Neonatal\u2010Perinatal Medicine, Department of Pediatrics University of Texas Southwestern Medical Center Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larry Steven","family":"Brown","sequence":"additional","affiliation":[{"name":"Parkland Health and Hospital System Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology University of Texas Southwestern Medical Center Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venkatakrishna","family":"Kakkilaya","sequence":"additional","affiliation":[{"name":"Division of Neonatal\u2010Perinatal Medicine, Department of Pediatrics University of Texas Southwestern Medical Center Dallas Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-023-01690-9"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41372-020-0764-4"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2013.83"},{"issue":"5","key":"e_1_2_10_5_1","article-title":"Surfactant Therapy via Thin Catheter in Preterm Infants With or at Risk of Respiratory Distress Syndrome","volume":"5","author":"Abdel\u2010Latif M. 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