Is There a Better Way to Give Surfactant to Preterm Infants?

Exogenous surfactant is a cornerstone of treatment for preterm infants with respiratory distress. Traditionally, surfactant is administered to infants who require intubation. However, some clinicians intubate infants to administer surfactant. In a parallel-group, randomized controlled trial conducted at 12 German neonatal intensive care units between 2007 and 2010, investigators examined the efficacy of surfactant administration without intubation in 220 spontaneously breathing preterm infants (gestational age, 26 weeks to 28 weeks and 6 days). All infants were supported with continuous positive airway pressure. When surfactant was needed, infants in the intervention group received it through a small-bore catheter inserted into the trachea …