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Updated: Jun 19, 2026

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Efficacy of Less Invasive Surfactant Administration (LISA) in Preterm Neonates With Respiratory Distress Syndrome: A
Xuezheng Sun1, Shaked Yarza1, Yuting Kuang2
1Chiesi USA Inc, Cary, NC, USA.
Background:
Less invasive surfactant administration (LISA) is increasingly used to treat respiratory distress syndrome (RDS) in preterm infants, but variation in treatment effects across clinical subgroups remains unclear.
Methods:
We conducted a systematic review and meta-analysis of randomized controlled trials published between 2010 and 2024 in MEDLINE, EMBASE, and CENTRAL comparing LISA with INtubation-SURfactant-Extubation (INSURE) in preterm infants with RDS. Random-effects generalized linear mixed models estimated pooled odds ratios with 95% confidence intervals. Prespecified subgroup analyses evaluated gestational age, surfactant type, antenatal corticosteroid exposure, and sedation.
Results:
Twenty-one trials including 2656 infants were analyzed. LISA was associated with lower odds of bronchopulmonary dysplasia, death, BPD or death, intubation or mechanical ventilation, and severe intraventricular hemorrhage. Greater benefits were observed in infants ≤ 34 weeks and those with higher antenatal steroid exposure.
Conclusion:
LISA improves key outcomes compared with INSURE and may provide greater benefits in specific clinical subgroups.
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