{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T13:53:02Z","timestamp":1780667582911,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"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":["Acta Paediatrica"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To compare less invasive surfactant administration (LISA) and intubation\u2010surfactant\u2010extubation (INSURE) in infants born before 28\u2009weeks gestational age (GA) by the need for mechanical ventilation (MV).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      LISA was introduced in 2017 in our unit without formal prior LISA\u2010specific training as an equal alternative to INSURE. Medical records (July 2017 to July 2021) were reviewed for infants born &lt;\u200928\u2009weeks gestation treated with LISA or INSURE. The primary outcome was needing MV within 72\u2009h, adjusted for potential confounders (including gestational age, birthweight, sex, mode of delivery and FiO\n                      <jats:sub>2<\/jats:sub>\n                      ) using logistic regression. Secondary outcomes included MV duration, respiratory support duration, first\u2010pass success rate in endotracheal tube or LISA catheter placement and neonatal morbidities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 108 infants (median 26\u2009weeks GA) were included: 51 receiving LISA, 57 receiving INSURE. LISA was associated with a lower need for MV within 72\u2009h (aOR: 0.40, 95% CI: 0.17\u20130.94) and during admission (aOR: 0.199, [0.075; 0.529]), although the duration of MV and any respiratory support were similar. The first\u2010pass success rate was high in both groups (75%). There were no differences in other secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LISA was associated with a reduced need for MV compared to INSURE, even when implemented without prior formal training.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apa.70041","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T06:21:20Z","timestamp":1741760480000},"page":"1868-1876","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Less Invasive Surfactant Administration Versus Intubate\u2010Surfactant\u2010Extubate: Associated With Reduced Mechanical Ventilation in Extremely Preterm Infants"],"prefix":"10.1111","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5690-3725","authenticated-orcid":false,"given":"C.","family":"Heiring","sequence":"first","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Copenhagen University Hospital  Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. S.","family":"Hedegaard","sequence":"additional","affiliation":[{"name":"Department of Neonatology G\u00f8dstrup Hospital  Herning Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. M.","family":"Carlsen","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Copenhagen University Hospital  Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Kristensen","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Copenhagen University Hospital  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Breindahl","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Copenhagen University Hospital  Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Copenhagen University Hospital  Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. T.","family":"Bay","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Copenhagen University Hospital  Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I. M. L.","family":"Nyegaard","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Copenhagen University Hospital  Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. B.","family":"Henriksen","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Adolescent Medicine Aarhus University Hospital  Aarhus Denmark"},{"name":"Perinatal Research Unit, Department of Clinical Medicine Aarhus University  Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Aunsholt","sequence":"additional","affiliation":[{"name":"Department of Neonatal and Pediatric Intensive Care Copenhagen University Hospital  Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.10244"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000528914"},{"key":"e_1_2_11_4_1","article-title":"Prophylactic Versus Selective Use of Surfactant in Preventing Morbidity and Mortality in Preterm Infants","volume":"3","author":"Rojas\u2010Reyes M. 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