{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T02:04:31Z","timestamp":1790215471059,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":["Clinical Respiratory J"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Pulmonary surfactant is essential for neonatal respiratory distress syndrome (RDS) management, yet national data on how surfactant is used in China are limited. We surveyed current practices and variation in surfactant availability and administration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In October\u2013December 2022, a nationwide cross\u2010sectional online survey was completed by one neonatologist from each of 394 hospitals across 30 provinces. Items covered surfactant availability (including delivery room access), product selection, dosing, timing, and administration techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Surfactant was available in 96.7% of hospitals; poractant alfa and calsurf were available in 88.6% and 58.1%, respectively. Only 51.6% of hospitals reported surfactant availability in delivery rooms. For the first dose, 200\u2009mg\/kg was preferred for poractant alfa (68.8%) and 100\u2009mg\/kg for calsurf (63.8%). The reported median time to first dose was 2.0\u2009h after birth; poractant alfa was administered sooner than calsurf (10 vs. 30\u2009min estimated administration time;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Most respondents (79.7%) reported giving surfactant after noninvasive ventilation failure in infants who subsequently required mechanical ventilation, with higher use in tertiary vs. secondary hospitals (82.1% vs. 71.7%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Intubation\u2010surfactant\u2010extubation (INSURE) and less invasive surfactant administration (LISA)\/minimally invasive surfactant therapy (MIST) were available in 86.5% and 49.7% of hospitals, respectively. Additionally, 25.1% of the respondents reported combining a surfactant with glucocorticoids for treating RDS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Surfactant use in China shows substantial between\u2010hospital variation, particularly in delivery room access and less invasive administration. Standardized training and improved resource allocation may reduce disparities and support timely, evidence\u2010based surfactant therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/crj.70228","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T05:03:46Z","timestamp":1788325426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary Surfactant Treatment for Preterm Infants With Respiratory Distress Syndrome: A Nationwide Survey"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8738-0637","authenticated-orcid":false,"given":"Haifeng","family":"Zong","sequence":"first","affiliation":[{"name":"Department of Neonatology Shenzhen Maternity &amp; Child Healthcare Hospital  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5093-0308","authenticated-orcid":false,"given":"Chuanzhong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Neonatology Shenzhen Maternity &amp; Child Healthcare Hospital  Shenzhen Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6746-2096","authenticated-orcid":false,"given":"Long","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neonatology Women and Children's Hospital of Chongqing Medical University, Chongqing Health Center for Women and Children  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Ji","sequence":"additional","affiliation":[{"name":"Department of Neonatology Children's Hospital of Shanxi  Taiyuan Shanxi China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3401-4243","authenticated-orcid":false,"given":"Rong","family":"Ju","sequence":"additional","affiliation":[{"name":"Department of Neonatology Chengdu Women's and Children's Central Hospital  Chengdu Sichuan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiangqin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neonatology Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neonatology Guiyang Maternal and Child Health Care Hospital\u2010Guiyang Children's Hospital  Guiyang Guizhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyun","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Neonatology Gansu Provincial Maternal and Child Care Hospital (Gansu Provincial Central Hospital)  Lanzhou Gansu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7649-4575","authenticated-orcid":false,"given":"Hui","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neonatology The First Hospital of Jilin University  Changchun Jilin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neonatology The First Affiliated Hospital of Anhui Medical University  Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Falin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neonatology The Third Affiliated Hospital of Zhengzhou University  Zhengzhou Henan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huayan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neonatology Guangzhou Women and Children's Medical Center, National Children's Medical Center for South Central Region  Guangzhou Guangdong China"},{"name":"Division of Neonatology Children's Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4571-4424","authenticated-orcid":false,"given":"Yuan","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Neonatology Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"MUNICH Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1159\/000499361"},{"issue":"11","key":"e_1_2_12_3_1","first-page":"994","article-title":"Newborn Respiratory Distress","volume":"92","author":"Hermansen C. 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