Immediate respiratory management of the preterm infant

SummaryInfants born prematurely have underdeveloped lungs characterised by both morphological and biochemical abnormalities. Respiratory distress syndrome (RDS) is the leading cause of morbidity and mortality in this population. Both surfactant replacement therapy with mechanical ventilation and continuous positive airway pressure (CPAP) have been shown to be of benefit. However, considerable controversy exists about how best to use these therapies. This paper will review the pathophysiology of RDS and the evidence supporting each of these treatments.