Baseline characteristics of the included studies
| Study | Population, settings Surfactant | Criteria for surfactant | LISA group | Intubation group | Comments |
|---|---|---|---|---|---|
| Göpel et al27 | GA: 26–28 weeks Germany, multi-centre (12 NICUs) Curosurf/bovine 100 mg/kg | Subjects on nCPAP; and FiO2 ≥0.3 for LISA group and variable Fio2 threshold (between 0.3 and 0.6) for intubation group | N=108 GA: 27.6 (0.8) weeks Birth weight*: 975 (244) g 2.5–5 Fr catheter Magill forceps AS: 96% | N=112 GA: 27.5 (0.8) weeks Birth Wt: 938 (205) g InSurE protocol: unclear AS: 96% | Use of premedication was at the discretion of the attending physicians. Not all patients received surfactant in either group. |
| Kanmaz et al28 | GA: <32 weeks Turkey, single centre Curosurf 100 mg/kg | Subjects on nCPAP with FiO2 ≥0.4 | N=100 GA: 28 (2) weeks Birth weight: 1093 (270) g 5 Fr feeding tube AS: 73% | N=100 GA 28.3 (2) weeks Birth weight: 1121 (270) g InSurE protocol: yes AS: 81% | No premedication was used during both procedures. |
| Mirnia et al29 | GA: 27–32 weeks Iran, multi-centre (3 NICUs) Curosurf 200 mg/kg | Subjects on nCPAP with FiO2 ≥0.3 | N=66 GA: 29.6 (1.7) weeks Birth weight: 1339 (406) g 5 Fr feeding tube AS: 66.7% | N=70 GA: 29.6 (1.7) weeks Birth weight: 1304 (331) g InSurE protocol: yes AS: 62.9% | Atropine for premedication |
| Bao et al30 | GA: 28–32 weeks China, single centre Curosurf 200 mg/kg | Subjects on nCPAP with FiO2 ≥0.3 (28–29 weeks) or ≥0.35 (30–32 weeks) | N=47 GA: 29.1 (1.5) weeks Birth weight: 1034 (221) g 16-guage catheter(∼5 Fr) AS: 89.4% | N=43 GA: 29.3 (1.6) weeks Birth weight: 1087 (198) g InSurE protocol: yes AS: 93% | |
| Mohammadizadeh et al31 | GA: <34 weeks Iran, multi-centre (2 NICUs) Curosurf 200 mg/kg | Subjects on nCPAP with FiO2 ≥0.3 or moderate-to-severe RDS (Silverman score ≥5) | N=19 GA: 30 (2) weeks Birth weight: 1289 (219) g 4 Fr feeding tube Magill forceps AS: 84.2% | N=19 GA 31 (2) weeks Birth weight: 1428 (272) g InSurE protocol: yes AS: 89.5% | Atropine for premedication |
| Kribs et al32 | GA: 23 to <27 weeks Germany, multi-centre (13 NICUs) Curosurf 100 mg/kg | Subjects on nCPAP with FiO2 ≥0.3 or moderate-to-severe RDS (Silverman score ≥5) | N=107 GA: 25.3 (1.1) weeks Birth weight: 711 (195) g 4 Fr catheter Magill forceps AS: 98.1% | N=104 GA: 25.2 (0.91) weeks Birth weight: 674 (165) g InSurE protocol: no (centres were advised to extubate as soon as possible) AS: 98.1% | Use of premedication was not specified. |
*Data are mean (SD) for all studies.
AS, antenatal steroids; Fio2, fractional inspired oxygen; GA, gestational age; InSurE, Intubation, Surfactant and Extubation; LISA, less invasive surfactant administration; NICU, neonatal intensive care unit; RDS, respiratory distress syndrome.