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Surfactant administration via a laryngeal or supraglottic airway (SALSA) has emerged as a method for surfactant delivery and may reduce the need for mechanical ventilation.1–3 By enabling surfactant instillation in spontaneously breathing infants without laryngoscopy, SALSA may be particularly attractive outside tertiary centres and in resource-limited settings. Currently, neither SALSA nor general use of supraglottic airway devices (SGADs) is widely implemented, partly due to the lack of procedural guidance and limited data on how SALSA is best performed.1 4