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Are LISA and ENSURE treatments equally good for preterm babies with respiratory distress syndrome?

high confidence  ·  Last reviewed May 20, 2026

LISA and ENSURE are two different ways to give surfactant to preterm babies with respiratory distress syndrome. A direct comparison study found that both methods result in a similar need for invasive mechanical ventilation within the first 72 hours. This suggests that neither technique is clearly superior to the other for this specific outcome.

What the research says

A randomized controlled trial involving 118 preterm neonates in North India directly compared LISA and ENSURE. The study found that the need for invasive mechanical ventilation within 72 hours was similar in both groups. The researchers noted that while LISA offers advantages over the original INSURE method, ENSURE was proposed to fix limitations of that older technique. The direct head-to-head comparison showed comparable outcomes for the primary outcome of ventilation need 2.

Other research supports the idea that different surfactant administration techniques may be equally effective. Experts state there is no firm consensus on one single optimal technique, and variations in practice exist because the original INSURE method was not fully described. ENSURE is now offered as an updated, standardized reference technique to increase safety and feasibility, but it is not proven to be better than LISA in direct trials 5.

While other studies look at different support methods like CPAP versus high-frequency oscillation, the specific comparison between LISA and ENSURE highlights that procedural differences do not necessarily lead to different rates of respiratory failure or death in the short term 24.

What to ask your doctor

  • Which surfactant administration technique does your hospital prefer, LISA or ENSURE?
  • Are there specific risks associated with one method versus the other for my baby's condition?
  • How does the choice between LISA and ENSURE affect the duration of respiratory support?
  • What are the long-term outcomes for babies treated with LISA compared to those treated with ENSURE?

This question is drawn from common patient questions about Pulmonology & Critical Care and answered using cited medical research. We do not provide individualized advice.