LAUSR

In the last decade, techniques supposed to provide a less invasive surfactant administration have been proposed to treat respiratory distress syndrome (RDS), and the interest in these methods has spread. These techniques are supposed to find a place within the general drive toward the reduction in the aggressiveness of neonatal critical care whenever it is possible. However, the so-called less invasive surfactant administration (LISA) or minimally invasive surfactant treatment (MIST) techniques represent an example of unjustified enthusiasm, as there is a lack of physiopathological and biological background supporting their hypothetical benefits [1]. These techniques have gained diffusion without following the clear regulatory pathway that should be required for innovative therapeutic methods [2] and have been tested in just a few trials, which were not free from relevant biases. Any trial or research project has limitations, but the majority of those investigating less invasive surfactant administration techniques are affected by similar flaws, and the main ones are [1, 3]: