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Related Experiment Video

Updated: Apr 4, 2026

Intratracheal Instillation of Stem Cells in Term Neonatal Rats

Intratracheal Instillation of Stem Cells in Term Neonatal Rats

Published on: May 4, 2020

Less Invasive Surfactant Administration in Extreme Preterm Infants: A Systematic Review and Meta-Analysis.

Shivashankar Diggikar^1,2, Paula Trif^3,4, Diana Mudura⁵

¹Department of Neonatology, Medicover Women and Children Hospital, Bengaluru, India.

|April 2, 2026

Summary

This summary is machine-generated.

Less Invasive Surfactant Administration (LISA/MIST) reduced mechanical ventilation (MV) in preterm infants compared to INSURE. However, LISA/MIST did not significantly impact bronchopulmonary dysplasia (BPD) or mortality rates.

Keywords:

Extremely preterm InSurE Less invasive surfactant administration Surfactant

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Area of Science:

Neonatalogy
Pediatric Pulmonology
Critical Care Medicine

Background:

Surfactant therapy is crucial for managing respiratory distress syndrome in preterm infants.
Different methods exist for surfactant administration, including Less Invasive Surfactant Administration (LISA/MIST) and Intubation-Surfactant-Extubation (INSURE).

Purpose of the Study:

To compare the efficacy and safety of LISA/MIST versus INSURE in infants less than 28 weeks' gestation.
To evaluate the impact of these surfactant administration methods on key neonatal outcomes.

Main Methods:

Systematic review and meta-analysis following PRISMA guidelines.
Inclusion of 26 studies for qualitative synthesis and 12 for quantitative analysis.
GRADE recommendations were used for quality assessment.

Main Results:

LISA/MIST was not associated with significant differences in Bronchopulmonary Dysplasia (BPD) or mortality compared to INSURE.
LISA/MIST significantly reduced the need for mechanical ventilation (MV) within 72 hours compared to INSURE (RR, 0.70).
When compared to general intubation methods, LISA/MIST demonstrated reductions in BPD, MV, death, IVH, pneumothorax, and ROP.

Conclusions:

LISA/MIST reduces MV use in extremely preterm infants but does not significantly alter BPD or mortality rates when compared to INSURE.
Findings require cautious interpretation due to limited study power and competing risks in this vulnerable population.