Surfactant treatment
Once criteria for surfactant administration have been met, natural surfactant (Poractant alfa, Curosurf ®, Chiesi, Parma, Italy) will be administered (200 mg/kg) according to the InSURE (Intubation-SURfactant-Extubation), LISA (Less-Invasive-Surfactant-Administration), or IN-REC-SURE (INtubation-RECtruitmen-SURfactant-Extubation) technique in both groups as per the enrollment center protocol.After surfactant administration, patients of both groups will be extubated within 30 min in the case of the InSURE method and IN-REC-SURE method (in presence of satisfactory respiratory drive) and will continue non-invasive ventilation support as per center protocol.Infants of both groups may receive a subsequent dose of surfactant (100 mg/kg of poractant alfa) using the same method if they fail non-invasive ventilation again during the following 12 to 24 h as per center standard care.