Dargaville PA, Orsini F, Wang X, et al. - In preterm infants with respiratory distress syndrome, no statistically significant reduction in the probability of the composite outcome of death or bronchopulmonary dysplasia was achieved following surfactant administration via a thin catheter.

• This is a randomized clinical trial comprising 485 infants with a gestational age of 25 to 28 weeks and respiratory distress syndrome.

• Infants were randomly assigned to the MIST (minimally invasive surfactant therapy) group (n = 241) or to the control group (n = 244); continuous positive airway pressure was continued thereafter in both groups unless specified intubation criteria were met.

• MIST delivered via a thin catheter at a fraction of inspired oxygen threshold of 0.30 or greater within 6 hours of birth relative to sham (control) treatment led to attainment of the composite outcome of death or bronchopulmonary dysplasia in 43.6% vs 49.6%, respectively, of infants in the two groups.

• This difference was not statistically significant.