{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:44:44Z","timestamp":1792053884664,"version":"4.4.0"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Preterm birth (&lt;\u200937 weeks) causes high neonatal mortality, with respiratory distress syndrome (RDS) as a major complication due to surfactant deficiency. Surfactant administered via several methods. This study compares effectiveness and complications of two different methods of surfactant therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This randomized clinical trial was conducted involving two groups of a total of 80 neonates aged 28\u201334 weeks who, based on clinical conditions, required surfactant administration. In the INSURE method, the infant is first intubated with an appropriate size endotracheal tube, subsequently, surfactant is administered in a controlled manner using a feeding catheter and 20\u2009cmH\n                      <jats:sub>2<\/jats:sub>\n                      O positive pressure ventilation (PPV) and 5 cmH\n                      <jats:sub>2<\/jats:sub>\n                      O positive end expiratory pressure (PEEP) with a T\u2010piece device, and in the MIST method, while the infant is on nasal CPAP with a PEEP of 5\u2009cmH\n                      <jats:sub>2<\/jats:sub>\n                      O, a thin feeding catheter is inserted into the trachea and Surfactant is then slowly administered at the same dose, the catheter is immediately removed and nasal CPAP is continued. And the outcomes included the duration of respiratory support, need for surfactant re\u2010administration, mechanical ventilation and complications such as pulmonary hemorrhage, pneumothorax evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      indicated that none of the infants in the MIST group developed pneumothorax, required a second dose of surfactant, or underwent mechanical ventilation, compared with 12.8% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.055), 10.3% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.123), and 10.3% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.123), respectively, in the INSURE group. similarly, the duration of CPAP support and oxygen therapy did not differ significantly between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although many of the findings did not reach statistical significance, MIST appears to be associated with potentially important clinical benefits that should not be overlooked. Further studies with larger sample sizes are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ppul.71874","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:53:13Z","timestamp":1792050793000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Surfactant Administration in Two Different Methods (MIST, INSURE) on the Short\u2010Term Outcome of Preterm Infants With Respiratory Distress Syndrome: A Randomized Clinical Trial"],"prefix":"10.1002","volume":"61","author":[{"given":"Fatemeh","family":"Heidarzadeh","sequence":"first","affiliation":[{"name":"Student Research Committee, Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0448-8694","authenticated-orcid":false,"given":"Samira","family":"Pournajaf","sequence":"additional","affiliation":[{"name":"Non\u2010Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Akbarian\u2010Rad","sequence":"additional","affiliation":[{"name":"Non\u2010Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nesae","family":"Bozorgnezhad","sequence":"additional","affiliation":[{"name":"Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemmat Gholinia","family":"Ahangar","sequence":"additional","affiliation":[{"name":"Health Research Institute, Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7427-2576","authenticated-orcid":false,"given":"Mohsen","family":"Haghshenas","sequence":"additional","affiliation":[{"name":"Non\u2010Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences Babol Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"issue":"9","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"5273","DOI":"10.3390\/ijerph19095273","article-title":"Lifelong Lung Sequelae of Prematurity","volume":"19","author":"Di Filippo P.","year":"2022","journal-title":"International Journal of Environmental Research and Public Health"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjpo-2023-002315"},{"key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"e710","DOI":"10.1016\/S2214-109X(19)30163-9","article-title":"National, Regional, and Global Levels and Trends in Neonatal Mortality Between 1990 and 2017, With Scenario\u2010Based Projections to 2030: a Systematic Analysis","volume":"7","author":"Hug L.","year":"2019","journal-title":"Lancet Global Health"},{"issue":"4","key":"e_1_2_11_5_1","article-title":"A Randomized Trial Comparing Surfactant Administration Using InSurE Technique and the Minimally Invasive Surfactant Therapy in Preterm Infants (28 to 34 Weeks of Gestation) With Respiratory Distress Syndrome","author":"Mosayebi Z.","year":"2017","journal-title":"Journal of Comprehensive Pediatrics"},{"issue":"1","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1186\/s12890-024-03429-4","article-title":"Comparative Efficacy and Safety of Pulmonary Surfactant Delivery Strategies in Neonatal RDS: A Network Meta\u2010Analysis","volume":"24","author":"Liu S.","year":"2024","journal-title":"BMC Pulmonary Medicine"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1159\/000528914","article-title":"European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update","volume":"120","author":"Sweet D. G.","year":"2023","journal-title":"Neonatology"},{"key":"e_1_2_11_8_1","volume-title":"BMC Pulmonary Medicine","author":"Shiyue L."},{"issue":"2","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"112","DOI":"10.5455\/medarh.2024.78.112-116","article-title":"Less Invasive Surfactant Administration (LISA) Versus INSURE Method in Preterm Infants: A Retrospective Study","volume":"78","author":"Dini G.","year":"2024","journal-title":"Medical Archives"},{"issue":"2","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3233\/NPM-230194","article-title":"Surfactant Administration Methods for Premature Newborns: LISA Vs. INSURE Comparative Analysis","volume":"17","author":"Mansouri M.","year":"2024","journal-title":"Journal of Neonatal\u2010Perinatal Medicine"},{"issue":"12","key":"e_1_2_11_11_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2023-083508","article-title":"Application of a New Type of Double\u2010Lumen Endotracheal Tube in Preterm Infants With Respiratory Distress Syndrome: Study Protocol for a Non\u2010Inferiority Randomised Controlled Trial (NISA)","volume":"14","author":"Gao J.","year":"2024","journal-title":"BMJ Open"},{"issue":"1","key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"e66","DOI":"10.1055\/s-0044-1788927","article-title":"MIST or INSURE in Preterm Infants With Respiratory Distress Syndrome","volume":"14","author":"Sayed M. K. M.","year":"2024","journal-title":"Journal of Child Science"},{"issue":"3","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"848","DOI":"10.12669\/pjms.39.3.7283","article-title":"Efficacy and Safety of Surfactant Administration by MIST and INSURE Techniques in Neonates With Respiratory Distress Syndrome: A Randomized Controlled Trial","volume":"39","author":"Kaleem A.","year":"2023","journal-title":"Pakistan Journal of Medical Sciences"},{"issue":"3","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1002\/ppul.26789","article-title":"Respiratory Function Testing for Guiding Ventilator Mode Conversion in Congenital Diaphragmatic Hernia","volume":"59","author":"Kimura S.","year":"2024","journal-title":"Pediatric Pulmonology"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-0603"},{"issue":"4","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"143","DOI":"10.12816\/0002647","article-title":"Comparison Outcome of Surfactant Administration Via Tracheal Catheterization During Spontaneous Breathing With INSURE","volume":"21","author":"Mirnia K.","year":"2013","journal-title":"Medical Journal of Islamic World Academy of Sciences"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-016-2789-4"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.10708"}],"container-title":["Pediatric Pulmonology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71874","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ppul.71874","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ppul.71874","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:53:17Z","timestamp":1792050797000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ppul.71874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":17,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/ppul.71874"],"URL":"https:\/\/doi.org\/10.1002\/ppul.71874","archive":["Portico"],"relation":{},"ISSN":["8755-6863","1099-0496"],"issn-type":[{"value":"8755-6863","type":"print"},{"value":"1099-0496","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2025-09-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e71874"}}