Less Invasive Surfactant Administration (LISA) in Extremely Preterm Neonates (24–28 Weeks Gestation): Neurodevelopmental and Pulmonary Outcomes at 2 Years

Background: Non-invasive surfactant administration techniques seek to deliver exogenous surfactant while avoiding positive-pressure mechanical ventilation.\n\nMethods: In this prospective study of 188 extremely premature neonates born between 24+0 and 28+6 weeks gestation, patients receiving LISA via thin catheter during spontaneous breathing on CPAP were compared with standard InSurE technique.\n\nResults: The LISA cohort demonstrated a significantly lower rate of mechanical ventilation within the first 72 hours (28.7% vs 54.3%, p < 0.001) and a lower incidence of bronchopulmonary dysplasia (18.1% vs 31.9%, p = 0.028).\n\nConclusion: LISA is safe, feasible, and significantly reduces the duration of invasive mechanical ventilation in extremely preterm infants.