Early Respiratory Response to Bovine Lipid Extract Surfactant Can Predict Failure of Minimally Invasive Surfactant Therapy

The authors aimed to evaluate short-term respiratory outcomes and identify predictors of failure in minimally invasive surfactant therapy (MIST) using high-volume bovine lipid extract surfactant (BLES) in neonates with respiratory distress syndrome. They found that 19.2% of neonates experienced MIST failure, with lower gestational age and birth weight, as well as higher oxygen needs prior to the procedure, being associated with failure. Notably, oxygen requirements at 1 and 6 hours post-MIST emerged as independent predictors of MIST failure, suggesting that early respiratory response can inform treatment decisions.