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  1. Martin Ward Platt

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LISA reviewed

Less Invasive Surfactant Administration (LISA) has always had intuitive appeal, and many clinicians have quietly adopted this technique while the evidence has been accumulating. Then again, intubation-surfactant-extubation (InSurE) is also appealing, and it too has become a popular practice. Both have clear advantages over leaving a baby intubated. So which approach is better, or is there no real difference? Aldana-Aguirre et al have now performed a systematic review and meta-analysis of 6 randomised trials to give a firm answer: LISA is definitely better. How much better? Significantly less ventilation and bronchopulmonary dysplasia, though unsurprisingly no impact on mortality. The number needed to treat to prevent a case of BPD from these pooled data is 20. But look at the forest plots: the secondary message here is that so many of the relevant studies were underpowered, and the answer only emerges when meta-analysis is done. See page F17

Oxygen resuscitation for the most preterm: high or low?

Another meta-analysis here, from Oei et al. This time the secondary message, which I will tell you first, is that the paper is a lesson in how important masking can be. The subjects were all babies under 28 …

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