• Zhao-Lan Cao, Jing-Jing Pan, Xian Shen, Xiao-Yu Zhou, Rui Cheng, Xiao-Guang Zhou, and Yang Yang.
• Department of Neonates, Children's Hospital of Nanjing Medical University, Nanjing, China.
• J Chin Med Assoc. 2020 Feb 1; 83 (2): 170-179.

BackgroundLess invasive surfactant administration (LISA) seems to have a good application prospect both in experimental models and patients with respiratory distress syndrome (RDS). Data regarding the effect of LISA procedure on RDS are conflicting.MethodsA search was conducted by two investigators involved in this research in PubMed, Embase, and Cochrane databases for studies in English and in Wanfang, VIP, and Cnki databases for Chinese studies (all last launched on December 18, 2018). Odds ratio and weighted mean difference were calculated using a random-effects or fixed-effects model, depending on the data type and heterogeneity of the included studies.ResultsThe comparison of effectiveness on RDS: (1) with respect to mechanical ventilation (<72 hours) and mechanical ventilation (all time periods). Data showed significant differences between LISA/control groups. (2) With respect to days of mechanical ventilation, data showed no significant differences between LISA/control groups. (3) With respect to bronchopulmonary dysplasia, the analysis showed that there was significant difference between LISA group and control group. (4) Regarding days of supplementary oxygen therapy and hospital stay, no significant differences were found. The comparison of possible complications of RDS: (1) data for mortality, pneumothorax and pulmonary hemorrhage showed no differences in the two groups. (2) Data for retinopathy of preterm comparison showed significant difference between the two groups. (3) Regarding intraventricular hemorrhage/periventricular leukomalacia, significant differences were found between the two groups.ConclusionBased on the above evidences, LISA is an effective and safe treatment for preterm infants with RDS.

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