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Less invasive surfactant administration (LISA) in preterm infants with respiratory distress syndrome avoids mechanical ventilation and may further reduce the risk of death or bronchopulmonary dysplasia.1 A recent European survey indicates that the percentage of centres using LISA increased, but with wide variation in procedure. In particular, there is no consensus about whether sedation should be used.2 International guidelines recommend sedation for intubation but it can hamper spontaneous breathing, which is necessary for LISA. Recently, a study compared two groups …
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