Survey shows large differences between the Nordic countries in the use of less invasive surfactant administration

Research output: Contribution to journalArticle


Aim: Less invasive surfactant administration (LISA), namely surfactant instillation through a thin catheter in the trachea during spontaneous breathing, is increasingly used for premature infants. We surveyed the use of this technique in the Nordic countries in autumn 2015. Methods: A link to a web-based survey of surfactant administration methods was emailed to the directors of all neonatal units in the Nordic Region, apart from Finland, where only the five university-based departments were invited. Results: Of the 73 units (85%) who responded, 23 (32%) said that they used LISA. The country rates were Iceland 100%, Norway 82%, Finland 60%, Denmark, including Faroe Island and Greenland, 11% and Sweden 9%. LISA was used in 62% of level three units, but only 14% of level two units and most commonly in babies with a gestational age of at least 26 weeks. Premedication was always or sometimes used by 78%. The main reasons for not using LISA were lack of familiarity with the technique (61%), no perceived benefit over other methods (22%) and concerns about patient discomfort (26%). Conclusion: Less invasive surfactant administration was used in 32% of Nordic neonatal units, most commonly in level three units. Premedication was used more often than previously reported.


External organisations
  • Karolinska Institutet
  • Helsinki University Central Hospital
  • Skåne University Hospital
  • Copenhagen University Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Health Care Service and Management, Health Policy and Services and Health Economy
  • Pediatrics


  • Less invasive surfactant administration, Nordic countries, Premature infants, Respiratory distress syndrome, Web-based survey
Original languageEnglish
Pages (from-to)382-386
JournalActa Paediatrica, International Journal of Paediatrics
Issue number3
Early online date2017 Jan 7
Publication statusPublished - 2017
Publication categoryResearch