Less invasive surfactant administration with specially designed semirigid catheter: Experience from a tertiary level neonatal unit of a lower middle-income country.

Clinical outcomes of 74 preterm neonates, who received surfactant replacement therapy (SRT), were collected retrospectively, to compare the following modes of administration: (1) less invasive surfactant administration (LISA) via a specially designed semirigid catheter (Surfcath), (2) INtubate-SURfactant-Extubate (INSURE) and (3) through endotracheal tube (ETT), in neonates requiring mechanical ventilation. The primary composite outcome of mortality or bronchopulmonary dysplasia (BPD) at 36 weeks' post-menstrual age was 41% in LISA, 38% in INSURE and 77% in ETT groups (p < 0.01), the difference being mainly due to the high incidence of mortality in the latter. LISA, via a specially designed semirigid catheter, was safe and feasible in preterm neonates.