{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:25:39Z","timestamp":1790101539356,"version":"4.0.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>There has been an endeavor in recent years, to administer surfactant by minimally invasive techniques to neonates with surfactant deficiency. The objective of this study was to compare the need for intubation and mechanical ventilation after surfactant delivery, using Less Invasive Surfactant Administration (LISA) technique and Intubation SURfactant Extubation (InSurE), in preterm infants with respiratory distress syndrome (RDS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a pilot randomized control trial (RCT) at a tertiary care center over a period of 18\u2009months. Preterm neonates with RDS (gestational age 28\u201336\u2009weeks) were randomized to receive surfactant within 6\u2009h of birth by InSurE or LISA. The primary outcome was need for intubation and mechanical ventilation within 72\u2009h of birth. Infants were followed until discharge for adverse events and complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 40 infants were analyzed (20 in each group). There was no difference in the need for intubation and mechanical ventilation within 72\u2009h of birth between the two groups [InSurE, 6 (30%) and LISA, 6 (30%), relative risk 1.0, 95% confidence interval 0.51\u20131.97]. About 15% of infants in both groups had adverse events during the procedure. There was no statistically significant difference in the rates of major complications or duration of respiratory support, hospital stay and mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>We found LISA to be feasible and equally effective as InSurE for surfactant administration in the treatment of RDS in preterm infants. Future larger RCTs are required to compare the efficacy and long-term outcomes of LISA with the standard invasive methods of surfactant administration.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/tropej\/fmab086","type":"journal-article","created":{"date-parts":[[2021,9,19]],"date-time":"2021-09-19T11:06:55Z","timestamp":1632049615000},"source":"Crossref","is-referenced-by-count":32,"title":["Less Invasive Surfactant Administration (LISA) vs. Intubation Surfactant Extubation (InSurE) in Preterm Infants with Respiratory Distress Syndrome: A Pilot Randomized Controlled Trial"],"prefix":"10.1093","volume":"67","author":[{"given":"Prince","family":"Pareek","sequence":"first","affiliation":[{"name":"Department of Neonatology, Bharati Vidyapeeth University Medical College, Pune, Maharashtra 411043, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujata","family":"Deshpande","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Bharati Vidyapeeth University Medical College, Pune, Maharashtra 411043, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4364-2041","authenticated-orcid":false,"given":"Pradeep","family":"Suryawanshi","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Bharati Vidyapeeth University Medical College, Pune, Maharashtra 411043, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Love Kumar","family":"Sah","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Janaki Medical College and Teaching Hospital Pvt. Ltd, Janakpur 45600, Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinmay","family":"Chetan","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Bharati Vidyapeeth University Medical College, Pune, Maharashtra 411043, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Maheshwari","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Westmead Hospital, Westmead 2145, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiran","family":"More","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Sidra Medicine, Doha 44074000, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,30]]},"reference":[{"key":"2021093023293647200_fmab086-B1","first-page":"CD007836","article-title":"Animal derived surfactant extract for treatment of respiratory distress syndrome","author":"Seger","year":"2009","journal-title":"Cochrane Database Syst Rev"},{"key":"2021093023293647200_fmab086-B2","first-page":"CD001149","article-title":"Synthetic surfactant for respiratory distress syndrome in preterm infants","volume":"1998","author":"Soll","year":"2000","journal-title":"Cochrane Database Syst Rev"},{"key":"2021093023293647200_fmab086-B3","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1203\/00006450-199709000-00016","article-title":"Manual ventilation with a few large breaths at birth compromises the therapeutic effect of subsequent surfactant replacement in immature lambs","volume":"42","author":"Bj\u00f6rklund","year":"1997","journal-title":"Pediatr Res"},{"key":"2021093023293647200_fmab086-B4","doi-asserted-by":"crossref","first-page":"1970","DOI":"10.1056\/NEJMoa0911783","article-title":"Early CPAP versus surfactant in extremely preterm infants","volume":"362","author":"Finer","year":"2010","journal-title":"N Engl J Med"},{"key":"2021093023293647200_fmab086-B5","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1056\/NEJMoa072788","article-title":"Nasal CPAP or intubation at birth for very preterm infants","volume":"358","author":"Morley","year":"2008","journal-title":"N Engl J Med"},{"key":"2021093023293647200_fmab086-B6","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1056\/NEJM199410203311603","article-title":"Surfactant therapy and nasal continuous positive airway pressure for newborns with respiratory distress syndrome. 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