Surfactant administration with a thin catheter inserted into the trachea

A randomized trial tested a new method of administering surfactant to preterm infants that avoids positive pressure ventilation. In spontaneously breathing infants surfactant was administered through a thin catheter is inserted into the trachea under laryngoscopy. Infants treated this way had a lower frequency of mechanical ventilation, a shorter median duration of ventilation, and a lower frequency of oxygen therapy at 28 days than control infants who were intubated and given surfactant the standard way.

Avoidance of mechanical ventilation by surfactant treatment of spontaneously breathing preterms. Gopel et al. 2012