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To examine the success rate of less invasive surfactant administration (LISA), to identify early predictive factors for the outcome of LISA and to compare neonatal outcomes between the LISA failure group and the group of infants who were successfully treated with LISA. A retrospective cohort study. Infants born at less than 33 weeks of gestation (n=158) and treated with LISA for respiratory distress syndrome. LISA was successful in 86 cases (54.4%), 72 preterm infants (45.6%) needed additional surfactant therapy and/or mechanical ventilation in th