Treatment and respiratory support modes for neonates with respiratory distress syndrome

TY - JOUR

T1 - Treatment and respiratory support modes for neonates with respiratory distress syndrome

AU - Dassios, Theodore

AU - Ambulkar, Hemant

AU - Greenough, Anne

PY - 2020/5/3

Y1 - 2020/5/3

N2 - Introduction: Respiratory distress syndrome (RDS) remains an important problem. Identifying effective treatments and respiratory support modes is essential. Areas covered: Current treatments and respiratory support modes and the evidence base for new therapies and respiratory modes have been examined. Methods:A literature search was undertaken using PubMed and Google Scholar. Expert opinion: It is now common to stabilise infants on non-invasive respiratory support in the delivery suite and give early selective surfactant to infants with RDS. Increasingly, less invasivesurfactant administration is used. Systemically administered corticosteroids should not be given in the perinatal period; inhaled budesonide has been associated with an increased mortality. Inhaled nitric oxide can be helpful in preterm infants with pulmonary hypertension. Caffeine should be routinely administered. Further research regarding stems cells is required. Post extubation, nasal intermittent positive pressure ventilation (NIPPV) rather than nasal continuous positive airway pressure (nCPAP) provides better support and humidified high flow nasal cannula (HHFNC) has similar efficacy to continuous positive airway pressure (CPAP). Volume targeting should be used for infants requiring intubation. There is insufficient evidence to determine the role of neurally adjusted ventilatory assist or whether closed loop automatic oxygen control improves long term outcomes.

AB - Introduction: Respiratory distress syndrome (RDS) remains an important problem. Identifying effective treatments and respiratory support modes is essential. Areas covered: Current treatments and respiratory support modes and the evidence base for new therapies and respiratory modes have been examined. Methods:A literature search was undertaken using PubMed and Google Scholar. Expert opinion: It is now common to stabilise infants on non-invasive respiratory support in the delivery suite and give early selective surfactant to infants with RDS. Increasingly, less invasivesurfactant administration is used. Systemically administered corticosteroids should not be given in the perinatal period; inhaled budesonide has been associated with an increased mortality. Inhaled nitric oxide can be helpful in preterm infants with pulmonary hypertension. Caffeine should be routinely administered. Further research regarding stems cells is required. Post extubation, nasal intermittent positive pressure ventilation (NIPPV) rather than nasal continuous positive airway pressure (nCPAP) provides better support and humidified high flow nasal cannula (HHFNC) has similar efficacy to continuous positive airway pressure (CPAP). Volume targeting should be used for infants requiring intubation. There is insufficient evidence to determine the role of neurally adjusted ventilatory assist or whether closed loop automatic oxygen control improves long term outcomes.

KW - Surfactant

KW - caffeine

KW - closed loop automatic oxygen control

KW - continuous positive airway pressure

KW - corticosteroids

KW - heated

KW - high flow nasal cannula

KW - high frequency oscillatory ventilation

KW - humidified

KW - less invasive surfactant administration (LISA)

KW - nebulization

KW - nitric oxide

KW - patient triggered ventilation

KW - volume targeted ventilation

UR - http://www.scopus.com/inward/record.url?scp=85086702956&partnerID=8YFLogxK

U2 - 10.1080/21678707.2020.1769598

DO - 10.1080/21678707.2020.1769598

M3 - Review article

SN - 2167-8707

VL - 8

SP - 145

EP - 156

JO - Expert opinion on orphan drugs

JF - Expert opinion on orphan drugs

IS - 5

M1 - doi.org/10.1080/21678707.2020.1769598

ER -