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, 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 analysed 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 drug 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. Standardised guidelines are needed to optimise clinical outcomes and reduce practice heterogeneity.