Review demonstrates that less invasive surfactant administration in preterm neonates leads to fewer complications.

Surfactant treatment of neonatal respiratory distress syndrome (RDS) was introduced into Europe during the 1990s. Meta-analyses have indicated that using less invasive surfactant administration (LISA) techniques on preterm neonates receiving continuous positive airway pressure (CPAP) results in improved survival rates without bronchopulmonary dysplasia. Surfactant should be administered early and ventilator settings adapted to changing oxygen requirements and lung mechanics. Side effects including initial bradycardia, oxygen desaturation, tube obstruction and isolated cases of pulmonary haemorrhage have been reported CONCLUSION: Less invasive surfactant therapy improves pulmonary outcomes in preterm neonates with RDS and should ideally be administered in combination with CPAP. This article is protected by copyright. All rights reserved.