{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T07:31:10Z","timestamp":1793950270815,"version":"4.8.0"},"reference-count":61,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T00:00:00Z","timestamp":1682467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Surfactant administration via a thin catheter (STC) is an alternative to surfactant administration post endotracheal intubation in preterm infants with respiratory distress syndrome (RDS); however, the benefits particularly in infants &lt;29 weeks\u2019 gestation and the neurodevelopmental outcomes remain unclear. Thus, our objective was to systematically review and meta-analyze the efficacy and safety of STC compared to intubation for surfactant or nasal continuous positive airway pressure (nCPAP) in preterm infants with RDS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Medical databases were searched until December 2022 for randomized controlled trials (RCTs) assessing STC compared to controls that included intubation for surfactant or nCPAP in preterm infants with RDS. The primary outcome was bronchopulmonary dysplasia (BPD) at 36 weeks gestation in survivors. Subgroup analysis was conducted comparing STC to controls in infants &lt; 29 weeks\u2019 gestation. The Cochrane risk of bias (ROB) tool was used and certainty of evidence (CoE) was rated according to GRADE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-six RCTs of 3349 preterm infants, in which half of the studies had low risk of bias, were included. STC decreased the risk of BPD in survivors compared to controls (17 RCTs; N = 2408; relative risk (RR) = 0.66; 95% confidence interval (CI) 0.51 to 0.85; number needed to treat for an additional beneficial outcome (NNTB) = 13; CoE: moderate). In infants &lt; 29 weeks\u2019 gestation, STC significantly reduced the risk of BPD compared to controls (6 RCTs, N = 980; RR 0.63; 95% CI 0.47 to 0.85; NNTB = 8; CoE: moderate).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Compared to controls, STC may be a more efficacious and safe method of surfactant delivery in preterm infants with RDS, including infants &lt; 29 weeks\u2019 gestation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0284792","type":"journal-article","created":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T13:43:01Z","timestamp":1682516581000},"page":"e0284792","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["Surfactant delivery via thin catheter in preterm infants: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6179-1932","authenticated-orcid":true,"given":"Telford Y.","family":"Yeung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Godze","family":"Kanmaz Kutman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aakash","family":"Pandita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleni","family":"Philippopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonny","family":"Jasani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,4,26]]},"reference":[{"key":"pone.0284792.ref001","doi-asserted-by":"crossref","unstructured":"Jackson CJ, Chapter 46: Respiratory disorders in the preterm infant. Avery\u2019s Newborn Diseases 2018. 10th edition. P.653-662.","DOI":"10.1016\/B978-0-323-40139-5.00046-2"},{"key":"pone.0284792.ref002","article-title":"Neonatal respiratory distress syndrome. 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Wenjuan","year":"2019","journal-title":"China Continuing Med Ed"},{"key":"pone.0284792.ref041","first-page":"226","article-title":"Less invasive surfactant administration in preterm infants with respiratory distress syndrome","volume":"29","author":"A Halim","year":"2019","journal-title":"J Colleg Phys Sur Paks"},{"key":"pone.0284792.ref042","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1007\/s00431-020-03682-9","article-title":"Minimally invasive surfactant therapy versus INSURE in preterm neonate of 28 to 34 weeks with respiratory distress syndrome on non-invasive positive pressure ventilation\u2013a randomized controlled trial.","volume":"179","author":"BK Gupta","year":"2020","journal-title":"Eur J Pediatric"},{"key":"pone.0284792.ref043","first-page":"1","article-title":"Minimally invasive surfactant administration for the treatment of neonatal respiratory distress syndrome: a multicentre randomized study in China.","volume":"8","author":"R Han","year":"2020","journal-title":"Front Pediatr"},{"key":"pone.0284792.ref044","first-page":"95","article-title":"Effect of minimally invasive inject of pulmonary surfactant through gastric tube in the treatment of neonatal respiratory distress syndrome.","volume":"6","author":"P Zhang","year":"2020","journal-title":"China Med Herald"},{"key":"pone.0284792.ref045","first-page":"299","article-title":"Clinical research of different pulmonary surfactant administration techniques on premature infants with respiratory distress syndrome","volume":"16","author":"F Wang","year":"2020","journal-title":"Chin J Obstet Gynecol Pediatr"},{"key":"pone.0284792.ref046","doi-asserted-by":"crossref","first-page":"431","DOI":"10.29309\/TPMJ\/2020.27.02.4176","article-title":"Efficacy of surfactant administration to preterm infants via thin catheter versus INSURE technique.","volume":"27","author":"M Riaz","year":"2020","journal-title":"Professional Med J"},{"key":"pone.0284792.ref047","doi-asserted-by":"crossref","first-page":"e19216","DOI":"10.1097\/MD.0000000000019216","article-title":"Wang. 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The OPTIMIST-A randomized clinical trial","volume":"326","author":"PA Dargaville","year":"2021","journal-title":"JAMA"},{"key":"pone.0284792.ref049","doi-asserted-by":"crossref","first-page":"3659","DOI":"10.21608\/ejhm.2021.201984","article-title":"MISA (Minimally invasive surfactant administration) versus INSURE (intubation, surfactant, extubation) in preterms less than 34 weeks with RDS.","volume":"85","author":"MI Garib","year":"2021","journal-title":"Egyptian J Hosp Med"},{"key":"pone.0284792.ref050","doi-asserted-by":"crossref","first-page":"fmab086","DOI":"10.1093\/tropej\/fmab086","article-title":"Less invasive surfactant administration (LISA) vs intubation surfactant extubation (INSURE) in preterm infnats with respiratory distress syndrome: a pilot randomized controlled trial.","volume":"67","author":"P Pareek","year":"2021","journal-title":"J Trop Pediatr"},{"key":"pone.0284792.ref051","doi-asserted-by":"crossref","first-page":"188","DOI":"10.3345\/cep.2021.00297","article-title":"Comparison of minimally invasive surfactant therapy with intubation surfactant administration and extubation for treating preterm infants with respiratory distress syndrome: a randomized clinical trial.","volume":"65","author":"MK Sabzehei","year":"2022","journal-title":"Clin Exp Pediatr"},{"key":"pone.0284792.ref052","article-title":"Surfactant administration in preterm babies (28\u201336 weeks) with respiratory distress syndrome: LISA versus INSURE, an open-label randomized controlled trial.","author":"A Mishra","year":"2022","journal-title":"Pediatr Pulmonol"},{"key":"pone.0284792.ref053","doi-asserted-by":"crossref","first-page":"1309","DOI":"10.1007\/s00431-020-03572-0","article-title":"Two-year outcome data suggest that less invasive surfactant administration (LISA) is safe. Results from the follow-up of the randomized controlled AMV (avoid mechanical ventilation) study","volume":"179","author":"E Herting","year":"2020","journal-title":"Eur J Pediatr"},{"key":"pone.0284792.ref054","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1111\/apa.15565","article-title":"Developmental outcome of extremely preterm infants is improved after less invasive surfactant administration application: developmental outcome after LISA","volume":"110","author":"K Mehler","year":"2021","journal-title":"Acta Paediatr"},{"key":"pone.0284792.ref055","first-page":"CD011672","article-title":"Surfactant therapy via thin catheter in preterm infants with or at risk of respiratory distress syndrome.","author":"ME Abdel-Latif","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"pone.0284792.ref056","doi-asserted-by":"crossref","first-page":"286","DOI":"10.2174\/1573396318666220404194857","article-title":"Thin-catheter surfactant application for respiratory distress syndrome in spontaneously breathing preterm infants: a meta-analysis of randomized clinical trials.","volume":"18","author":"H Kesler","year":"2022","journal-title":"Curr Pediatr Rev"},{"key":"pone.0284792.ref057","first-page":"1","article-title":"Surfactant lung delivery with LISA and INSURE in adult rabbits with respiratory distress","volume":"15","author":"F Ricci","year":"2021","journal-title":"Pediatr Res"},{"key":"pone.0284792.ref058","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1038\/pr.2014.66","article-title":"Effects of less-invasive surfactant administration on oxygentation, pulmonary surfactant distribution, and lung compliance in spontaneously breathing preterm lambs","volume":"76","author":"HJ Niermarkt","year":"2014","journal-title":"Pediatr Res"},{"key":"pone.0284792.ref059","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1053\/j.semperi.2018.09.013","article-title":"An update on pulmonary and neurodevelopmental outcomes of bronchopulmonary dysplasia.","volume":"42","author":"JLY Cheong","year":"2018","journal-title":"Semin Perinatol"},{"key":"pone.0284792.ref060","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.1111\/apa.16499","article-title":"Multi-centre randomised trial of invasive and less invasive surfactant delivery methods showed similar spirometry results at 5\u20139 years of age","volume":"111","author":"W Gopel","year":"2022","journal-title":"Acta Paediatr"},{"key":"pone.0284792.ref061","doi-asserted-by":"crossref","first-page":"101230","DOI":"10.1016\/j.siny.2021.101230","article-title":"LISA\/MIST: Complex clinical problems almost never have easy solutions.","volume":"26","author":"D De Luca","year":"2021","journal-title":"Semin Fetal Neonatal Med"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0284792","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T13:44:15Z","timestamp":1682516655000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0284792"}},"subtitle":[],"editor":[{"given":"Harald","family":"Ehrhardt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,4,26]]},"references-count":61,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4,26]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0284792","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,26]]}}}