MIST/LISA in Portugal: National Survey of Clinical Practice

Background: Minimally/Less Invasive Surfactant Therapy/Administration (MIST/LISA) is increasingly used for surfactant delivery in preterm infants with respiratory distress syndrome (RDS), aiming to reduce complications associated with invasive methods.Despite its growing adoption, variations in clinical practice remain.Objective: To evaluate MIST/LISA use in Portuguese neonatal intensive care units (NICUs) and identify variations in practice.Methods: A national, anonymous questionnaire was distributed to neonatologists.The survey explored surfactant administration techniques, experience with MIST/LISA, device preferences, premedication strategies, and protocols.Responses were analyzed descriptively.Results: Fifty-two responses were collected.Most respondents reported using MIST/LISA (87%), preferring it over INSURE or standard intubation.Practices varied widely in pre-intervention drugs use and catheter choice.Surfcath was the most used device (71%).Only one-third consistently used pre-sedation. Conclusion:MIST/LISA is widely implemented in Portuguese NICUs, but substantial variability exists.Standardized guidelines are needed to optimize clinical outcomes and reduce practice heterogeneity.