{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T10:09:17Z","timestamp":1790330957695,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"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":["J Paediatrics Child Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine the effectiveness and feasibility of prophylactic thin\u2010catheter surfactant (TC\u2010S) in the delivery room in preventing intubation and mechanical ventilation in the first week after birth in extreme preterm infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The Extreme Preterm Infants Non\u2010invasive Surfactant Trial (EPINIST) was a pilot randomised controlled trial conducted from 2018 to 2023. We included infants from 24\n                      <jats:sup>+0<\/jats:sup>\n                      to 27\n                      <jats:sup>+6<\/jats:sup>\n                      \u2009weeks' gestation with valid informed consent obtained before delivery. Infants who were unlikely to survive, had congenital anomalies affecting breathing or survival or whose mothers had clinical chorioamnionitis or mid\u2010second\u2010trimester prolonged rupture of membranes were excluded. Infants were randomised to nasal continuous positive airway pressure with prophylactic TC\u2010S while spontaneously breathing (intervention arm) or intubation, prophylactic surfactant and brief mechanical ventilation (ETT\u2010S; control arm). The primary outcome measures were the need for intubation and mechanical ventilation within the first week after birth, as well as the occurrence of serious adverse events during the intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty\u2010two infants were randomised, 33 infants to the TC\u2010S and 29 infants to the intubation and surfactant group. Of the infants randomised to the TC\u2010S group, only 11 (33.3%) required intubation and mechanical ventilation within the first week after birth, compared with 28 (96.6%) in the ETT\u2010S group. No severe adverse events were noted in the TC\u2010S group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Delivery\u2010room prophylactic TC\u2010S was feasible and reduced exposure to protocol\u2010directed mechanical ventilation. A larger definitive trial powered for clinical outcomes is warranted.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      Australia and New Zealand Clinical Trials Registry: ACTRN12617001204336p\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jpc.70573","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:48:37Z","timestamp":1790329717000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Delivery\u2010Room Prophylactic Thin\u2010Catheter Surfactant in Extremely Preterm Infants: A Multicentre Pilot Randomised Controlled Trial"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4138-9344","authenticated-orcid":false,"given":"Joseph K.","family":"Tauro","sequence":"first","affiliation":[{"name":"Gold Coast University Hospital  Gold Coast Queensland Australia"},{"name":"Griffith University  Gold Coast Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Osborn","sequence":"additional","affiliation":[{"name":"Royal Prince Alfred Hospital  Camperdown New South Wales Australia"},{"name":"Central Clinical School, School of Medicine Sydney University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4294-8604","authenticated-orcid":false,"given":"Jennifer","family":"Middleton","sequence":"additional","affiliation":[{"name":"Royal Prince Alfred Hospital  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1305-1005","authenticated-orcid":false,"given":"Haribalakrishna","family":"Balasubramanian","sequence":"additional","affiliation":[{"name":"Department of Neonatology Surya Hospitals  Mumbai Maharashtra India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-2933","authenticated-orcid":false,"given":"Mohamed E.","family":"Abdel\u2010Latif","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Centenary Hospital for Women and Children Canberra Hospital  Canberra Australian Capital Territory Australia"},{"name":"Discipline of Neonatology, School of Medicine and Psychology, College of Science and Medicine Australian National University  Canberra Australian Capital Territory Australia"},{"name":"Department of Public Health, College of Science, Health and Engineering La Trobe University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011672.pub2"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1159\/000528914"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.21892"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.0504"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015\u20103985"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2300183"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003063.pub3"},{"key":"e_1_2_12_9_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i5239","article-title":"CONSORT 2010 Statement: Extension to Randomised Pilot and Feasibility Trials","volume":"355","author":"Eldridge S. 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