#386 - 🟢 HOT TOPICS 2025 COVERAGE - Should Late Preterm Infants Receive Early Surfactant for Respiratory Distress?

Dr. Elaine Boyle, Professor of Neonatal Medicine at University of Leicester, presents the SURFON trial evaluating early surfactant versus expectant management in 34-38 week infants with respiratory distress. This pragmatic trial enrolled infants requiring 30-45% oxygen or non-invasive support. Primary outcomes showed no difference in hospital length of stay or progression to severe respiratory disease. Early surfactant reduced NICU duration and non-invasive support by less than one day each, with borderline pneumothorax increase requiring treatment of 80+ infants to prevent one case. Findings suggest watch-and-wait approaches remain safe and reasonable for this population, though this group requires continued research given their potential for severe illness.