LISA surfactant technique — RACP Paediatrics MCQ

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ModerateNeonatalLISA surfactant techniqueRACP Paediatrics

A 29-week premature infant on CPAP has increasing FiO2 requirement (now 0.35). The decision is made to administer surfactant. What is the preferred technique that allows surfactant delivery while maintaining spontaneous breathing on CPAP?

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Correct answer: A — Surfactant via LISA/MIST technique

LISA (Less Invasive Surfactant Administration) or MIST (Minimally Invasive Surfactant Therapy) involves passing a thin catheter through the vocal cords under direct laryngoscopy and instilling surfactant while the infant continues to breathe spontaneously on CPAP. This avoids intubation and mechanical ventilation. Evidence shows reduced BPD compared to intubation-surfactant-extubation.

Reference: RCH Melbourne – 2023 – Surfactant CPG; RACP Paediatric Curriculum – Neonatology