Less invasive surfactant administration: Will it change the outcome of preterm infants with respiratory distress syndrome?

摘要

Respiratory distress syndrome (RDS) is a common acute respiratory dysfunction in preterm infants. Its major pathogenesis is due to insufficiency of pulmonary surfactant and fail to effectively open their lungs after birth. Non-invasive ventilation is usually the first choices for preterm infants who can breathe spontaneously after birth. Early nasal continuous positive airway pressure (NCPAP) with or without non-invasive positive pressure ventilation (NIPPV) has become standard initial respiratory supports for those infants with mild to moderate RDS in many neonatal intensive care units. However, NCPAP/NIPPV failure may occur in some cases who require intubation some hours later. Invasive mechanical ventilations supports gas exchange for patients with respiratory failure or significant apnea, but the ventilation-related complications are well known. Searching better respiratory management protocol continues a major goal to reduce complications and improve outcome of preterm infants with moderate to severe RDS.