Navigating the Numerous Options and Decisions for Providing Non-Invasive Respiratory Support in the Management of Infants With Pulmonary Insufficiency

Non-invasive respiratory support has re-emerged as an important treatment strategy for managing infants with pulmonary insufficiency. Current clinical practice is primarily guided by personal preference and experience due in part to the absence of large, randomized controlled trials aimed at evaluating the various treatment strategies. Definitive guidelines regarding best practices remain poorly defined. Clinicians have numerous options to choose from and many decisions to make regarding the clinical use of non-invasive respiratory support. This article reviews many of these options and decisions, specifically, the types of devices currently available, patient interfaces, surfactant administration, patient assessment and positioning, and weaning strategies.