Materiały źródłowe

• #1 Newborn Respiratory Distress | AAFP

  https://www.aafp.org/pubs/afp/issues/2015/1201/p994.html

  Antenatal corticosteroids given between 24 and 34 weeks’ gestation decrease respiratory distress syndrome risk with a number needed to treat of 11. […] Reduction of premature births and cesarean deliveries decreases respiratory distress cases, with prenatal care being crucial to prevention. […] Antenatal corticosteroid use in threatened preterm deliveries from 24 to 34 weeks’ gestation significantly reduces the incidence and severity of respiratory distress. […] Because cesarean delivery is a risk factor for respiratory distress, especially in premature infants, reducing these surgeries when possible could reduce the incidence of the condition. […] The INSURE (intubate, administer surfactant, extubate to nasal continuous positive airway pressure) strategy should be used to reduce mechanical ventilation, air leak syndromes, and progression to bronchopulmonary dysplasia. […] Prophylactic and rescue therapy with natural surfactants in newborns with RDS reduces air leaks and mortality.

• #2 Prevention and Treatment of Respiratory Distress Syndrome in Preterm Neonates – PubMed

  https://pubmed.ncbi.nlm.nih.gov/29789058/

  Respiratory distress syndrome (RDS) impacts a high proportion of preterm neonates, resulting in significant morbidity and mortality. Advances in pharmacotherapy, specifically antenatal corticosteroids and postnatal surfactant therapy, have significantly reduced the incidence and impact of neonatal RDS. Antenatal corticosteroids accelerate fetal lung maturation by increasing the activity of enzymes responsible for surfactant biosynthesis, resulting in improved lung compliance. Maternal antenatal corticosteroid treatment has improved survival of preterm neonates and lowered the incidence of brain injury. After birth, exogenous surfactant administration improves lung compliance and oxygenation, resulting in reductions in the incidence of pneumothorax and of death. […] Future research will identify the optimal surfactant product, timing of the initial dose, and mode of delivery.

• #3 Respiratory Distress Syndrome (RDS) in Premature Babies – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=respiratory-distress-syndrome-rds-in-premature-babies-90-P02371

  Preventing a premature birth is the main way to prevent RDS. […] When a premature birth cant be prevented, you may be given corticosteroids before delivery. These medicines may greatly lower the risk and severity of RDS in the baby. These steroids are often given between 24 and 34 weeks of pregnancy to women at risk of early delivery. They may sometimes be given up to 37 weeks. But if the delivery is very quick or unexpected, there may not be time to give the steroids. Or they may not have a chance to start working.

• #4 Respiratory Distress Syndrome (RDS) | Rady Children’s Hospital

  https://www.rchsd.org/programs-services/neonatology/conditions-treated/respiratory-distress-syndrome-rds/

  Premature infants are highly vulnerable to respiratory distress syndrome (RDS), making prevention of premature birth a crucial approach to minimize the risk. […] When premature delivery cannot be prevented, healthcare providers often prescribe steroid medications to expectant mothers before delivery to reduce the severity of RDS. […] The good news is that there are treatments available to help your baby overcome RDS. One common treatment is surfactant therapy, which helps improve their lung function and prevent complications. […] It’s important for you as a parent to be vigilant and aware of any signs of respiratory distress in your premature baby. If you notice any breathing difficulties or changes in their oxygen levels, it’s crucial to seek medical attention promptly.

• #5 Neonatal Respiratory Distress Syndrome

  https://www.healthline.com/health/neonatal-respiratory-distress-syndrome

  Preventing premature delivery lowers the risk of neonatal RDS. To reduce the risk of premature delivery, get consistent prenatal care throughout pregnancy and avoid smoking, illicit drugs, and alcohol. […] If a premature delivery is likely, the mother may receive corticosteroids. These drugs promote faster lung development and production of surfactant, which is very important to fetal lung function.

• #6 FloridaHealthFinder | Neonatal respiratory distress syndrome | Health Encyclopedia | FloridaHealthFinder

  https://quality.healthfinder.fl.gov/health-encyclopedia/HIE/1/001563

  Taking steps to prevent premature birth can help prevent neonatal RDS. Good prenatal care and regular checkups beginning as soon as a woman discovers she is pregnant can help avoid premature birth. […] The risk of RDS can also be lessened by the proper timing of delivery. An induced delivery or cesarean may be needed. A lab test can be done before delivery to check the readiness of the baby’s lungs. Unless medically necessary, induced or cesarean deliveries should be delayed until at least 39 weeks or until tests show that the baby’s lungs have matured. […] Medicines called corticosteroids can help speed up lung development before a baby is born. They are often given to pregnant women between 24 and 34 weeks of pregnancy who seem likely to deliver in the next week. More research is needed to determine if corticosteroids may also benefit babies who are younger than 24 or older than 34 weeks. […] At times, it may be possible to give other medicines to delay labor and delivery until the steroid medicine has time to work. This treatment may reduce the severity of RDS. It may also help prevent other complications of prematurity. However, it will not totally remove the risks.

• #7 FloridaHealthFinder | Neonatal respiratory distress syndrome | Health Encyclopedia | FloridaHealthFinder

  https://quality.healthfinder.fl.gov/health-encyclopedia/HIE/1/001563

  Taking steps to prevent premature birth can help prevent neonatal RDS. Good prenatal care and regular checkups beginning as soon as a woman discovers she is pregnant can help avoid premature birth. […] The risk of RDS can also be lessened by the proper timing of delivery. An induced delivery or cesarean may be needed. A lab test can be done before delivery to check the readiness of the baby’s lungs. Unless medically necessary, induced or cesarean deliveries should be delayed until at least 39 weeks or until tests show that the baby’s lungs have matured. […] Medicines called corticosteroids can help speed up lung development before a baby is born. They are often given to pregnant women between 24 and 34 weeks of pregnancy who seem likely to deliver in the next week. More research is needed to determine if corticosteroids may also benefit babies who are younger than 24 or older than 34 weeks. […] At times, it may be possible to give other medicines to delay labor and delivery until the steroid medicine has time to work. This treatment may reduce the severity of RDS. It may also help prevent other complications of prematurity. However, it will not totally remove the risks.

• #8 Infant Respiratory Distress Syndrome: What to know

  https://www.medicalnewstoday.com/articles/infant-respiratory-distress-syndrome

  The best way to prevent infant RDS is to prevent premature birth, which takes place between 20 and 37 weeks of gestational age. […] Some strategies to prevent preterm birth include: progesterone supplementation, for people with short cervixes; avoiding smoking during pregnancy; avoiding alcohol during pregnancy; avoiding recreational drugs during pregnancy.

• #9 Respiratory Distress Syndrome (RDS): Birth Injury Attorneys

  https://www.abclawcenters.com/blog/respiratory-distress-syndrome-rds/

  Much of preventing RDS comes down to preventing premature birth, or providing proper medical care if premature birth is inevitable. […] To prevent premature birth, it is essential that doctors provide good prenatal care. This includes checking for complications that increase the risk of premature birth, and providing medical interventions (such as a cervical cerclage or progesterone therapy) as necessary. […] If it is necessary to deliver early, doctors may be able to give the mother corticosteroid injections, which can help to speed up the baby’s lung development and surfactant production.

• #10 Causes and treatment of neonatal respiratory distress syndrome | Nursing Times

  https://www.nursingtimes.net/respiratory/causes-and-treatment-of-neonatal-respiratory-distress-syndrome-27-07-2004/

  The vast majority of babies who develop RDS do so because they are premature. Attempts to prevent early delivery are therefore a major consideration. A number of strategies can be used. […] Health education for pregnant women and their families can play an important role in preventing premature birth. […] Women who have had several second-trimester miscarriages and/or preterm deliveries may benefit from prophylactic cerclage of the cervix in early pregnancy. […] Antibiotics are used to prevent preterm delivery or delay it long enough to allow the baby’s lungs to develop. […] Many clinical trials have demonstrated that prenatal corticosteroids reduce the risk of RDS. The greatest benefit is seen when the interval between the start of treatment and delivery is more than 48 hours and less than seven days. Steroids accelerate maturation of foetal lungs by stimulating type II pneumocytes to produce the phospholipids necessary for surfactant production.

• #11 Neonatal Respiratory Distress Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560779/

  Deterrence and Patient Education: While the goal of preventing preterm birth altogether continues to be investigated, RDS can be reduced by the administration of antenatal corticosteroids. Administration of antenatal corticosteroids significantly reduces the incidence of RDS and the need for mechanical ventilation. The use of antenatal corticosteroids decreased the incidence of RDS in a review of 21 studies and 4083 infants with a reduction in neonatal and fetal death in a review of 3627 infants in 13 studies. It has also been shown to reduce infant mortality and periventricular leukomalacia. Of note, there were no statistically significant increases in maternal mortality with the administration of antenatal corticosteroids. […] Maternal antenatal corticosteroids are recommended for possible preterm delivery in the next seven days between 23rd and 34th week gestational age. Some institutions offer antenatal corticosteroids at 22 weeks if anticipating delivery within the next week. Despite multiple interventions targeting various etiologies, the goal of preventing preterm birth remains elusive.

• #12 Neonatal Respiratory Distress Syndrome | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/37547

  While the goal of preventing preterm birth altogether continues to be investigated, RDS can be reduced by the administration of antenatal corticosteroids. Administration of antenatal corticosteroids significantly reduces the incidence of RDS and the need for mechanical ventilation. The use of antenatal corticosteroids decreased the incidence of RDS in a review of 21 studies and 4083 infants with a reduction in neonatal and fetal death in a review of 3627 infants in 13 studies. It has also been shown to reduce infant mortality and periventricular leukomalacia. Of note, there were no statistically significant increases in maternal mortality with the administration of antenatal corticosteroids. […] Maternal antenatal corticosteroids are recommended for possible preterm delivery in the next seven days between 23rd and 34th week gestational age. Some institutions offer antenatal corticosteroids at 22 weeks if anticipating delivery within the next week. Despite multiple interventions targeting various etiologies, the goal of preventing preterm birth remains elusive.

• #13 Respiratory Distress Syndrome (RDS)

  https://healthlibrary.osfhealthcare.org/Library/PreventionGuidelines/90,P02371

  Preventing a premature birth is the main way to prevent RDS. […] When a premature birth cant be prevented, you may be given corticosteroids before delivery. These medicines may greatly lower the risk and severity of RDS in the baby. These steroids are often given between 24 and 34 weeks of pregnancy to those at risk of early delivery. They may sometimes be given up to 37 weeks. But if the delivery is very quick or unexpected, there may not be time to give the steroids. Or they may not have a chance to start working. […] Key points about RDS: Preventing a premature birth is the main way to prevent RDS.

• #14 Respiratory Distress Syndrome (RDS) | Birth Injury Lawyers

  https://www.nationalbirthinjurylaw.com/respiratory-distress-syndrome

  Prevention of neonatal respiratory distress syndrome largely boils down to prevention of preterm birth and administration of proper treatment when preterm birth is unavoidable. Proper monitoring and care during pregnancy is vital so that the risk of premature birth is identified, and appropriate medical interventions are made. […] When preterm delivery between 24 and 34 weeks of gestation is necessary, the medical providers should consider administering corticosteroid therapy to promote the babys lung development and sufficient production of surfactant. Two doses of betamethasone 12 mg or four doses of dexamethasone 6 mg may be delivered to the mother at least 48 hours prior to delivery in order to induce surfactant production in the babys lungs. […] In absence of corticosteroid therapy during pregnancy, prophylactic surfactant therapy may be administered to the premature baby who is at a high risk of developing respiratory distress syndrome. Studies have shown that surfactant therapy given through the trachea (intratracheal) may reduce the risk of severe lung complications and neonatal death.

• #15 Respiratory Distress in the Newborn | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/1001/p987.html

  Prenatal administration of corticosteroids between 24 and 34 weeks’ gestation reduces the risk of respiratory distress syndrome of the newborn when the risk of preterm delivery is high. […] Data suggest that prenatal administration of corticosteroids 48 hours before elective cesarean delivery at 37 to 39 weeks’ gestation reduces the incidence of transient tachypnea of the newborn; however, this has not become common practice. […] Prenatal administration of corticosteroids between 24 and 34 weeks’ gestation reduces the risk of respiratory distress syndrome when the risk of preterm delivery is high, with an odds ratio of 0.53.

• #16 Management of respiratory distress syndrome in moderate/late preterm neonates: A Delphi consensus | Anales de Pediatría

  https://www.analesdepediatria.org/en-management-respiratory-distress-syndrome-in-articulo-S234128792400262X

  Prevention and antenatal corticosteroid administration: Regarding antenatal corticosteroid administration, 77% of panellists considered that the current evidence is insufficient to adequately establish the balance of benefits and harms in threatened preterm labour at 34-36 weeks of gestation, and 73% agreed not to recommend corticosteroid administration from week 34. […] All panellists agreed not to recommend an additional dose of corticosteroids between 34 and 36 weeks of gestation in women at high risk of preterm delivery if a first course had been administered before 34 weeks. Most panellists agreed that antenatal corticosteroid administration offers respiratory benefits (76%). The reasons for not recommending corticosteroid administration between 34 and 36 weeks of gestation included an increased risk of hypoglycaemia in the newborn (79%) and a potential deleterious impact on long-term neurodevelopmental outcomes (83%).

• #17 Infant Respiratory Distress Syndrome (IRDS)

  https://patient.info/doctor/infant-respiratory-distress-syndrome

  Antenatal corticosteroids (dexamethasone) accelerate fetal surfactant production and lung maturation. They have been shown to reduce infant respiratory distress syndrome, intraventricular haemorrhage and mortality by 40%. […] Delaying premature birth. Tocolytics – eg, atosiban, nifedipine or ritodrine – may delay delivery by 48 hours and therefore enable time for antenatal corticosteroids to be given. […] Good control of maternal diabetes. […] Avoid hypothermia in the neonate.

• #18 Respiratory Distress Syndrome in Neonates – Pediatrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pediatrics/respiratory-problems-in-neonates/respiratory-distress-syndrome-in-neonates

  When a fetus must be delivered between 24 weeks and 34 weeks, giving the mother betamethasone or dexamethasone before delivery induces fetal surfactant production and reduces the risk of RDS or decreases its severity. […] Neonates who completed 30 weeks gestation, especially those who were not exposed to antenatal corticosteroids, are at high risk of developing RDS. Giving prophylactic intratracheal surfactant therapy to these neonates has been shown to decrease risk of neonatal death and certain forms of pulmonary morbidity (eg, pneumothorax). […] If preterm delivery is anticipated, assess lung maturity by testing amniotic fluid for lecithin/sphingomyelin ratio, foam stability, or the surfactant/albumin ratio. […] Give the mother several doses of a parenteral corticosteroid (betamethasone, dexamethasone) if time allows and she must deliver between 24 weeks and 34 weeks gestation; corticosteroids induce fetal surfactant production and reduce the risk and/or severity of RDS. […] Give respiratory support as needed and treat with intratracheal surfactant if the infant requires immediate intubation or has worsening respiratory status on nasal continuous positive airway pressure.

• #19 Infant respiratory distress syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Infant_respiratory_distress_syndrome

  Giving the baby’s mother glucocorticoids speeds the production of surfactant. For very premature deliveries, a glucocorticoid is given without testing the fetal lung maturity. The American College of Obstetricians and Gynecologists (ACOG), Royal College of Medicine and other major organizations have recommended antenatal glucocorticoid treatment for women at risk for preterm delivery prior to 34 weeks of gestation. Multiple courses of glucocorticoid administration, compared with a single course, do not seem to increase or decrease the risk of death or neurodevelopmental disorders of the child. […] In pregnancies of longer than 30 weeks, the fetal lung maturity may be tested by sampling the amount of surfactant in the amniotic fluid by amniocentesis, wherein a needle is inserted through the mother’s abdomen and uterus. Several tests are available that correlate with the production of surfactant. These include the lecithin-sphingomyelin ratio („L/S ratio”), the presence of phosphatidylglycerol (PG), and, more recently, the surfactant/albumin (S/A) ratio. For the L/S ratio, if the result is less than 2:1, the fetal lungs may be deficient in surfactant. The presence of PG usually indicates fetal lung maturity. For the S/A ratio, the result is given as milligrams of surfactant per gram of protein. A S/A ratio less than 35 indicates immature lungs, between 35 and 55 is indeterminate, and greater than 55 indicates mature surfactant production (correlating with an L/S ratio of 2.2 or greater).

• #20 Respiratory Distress Syndrome of the Newborn | RT

  https://respiratory-therapy.com/public-health/pediatrics/neonatal/respiratory-distress-syndrome-of-the-newborn/

  Most important in decreasing the incidence of RDS is prevention of prematurity, including avoidance of unnecessary and poorly timed cesarean sections. […] The two major management approaches to prevent the development of RDS are the use of antenatal treatment of women in preterm labor with glucocorticoid hormone to accelerate fetal lung maturation and the early use of surfactant replacement therapy. […] Prophylactic or preventive surfactant administration is defined as endotracheal intubation and surfactant administration to infants at high risk of developing RDS. […] Together with antenatal corticosteroid treatment, the use of prophylactic surfactant has made the greatest contribution to decreasing the incidence of RDS and its associated mortality and morbidity.

• #21 Neonatal Respiratory Distress Syndrome and Its Treatment with Artificial Surfactant | Embryo Project Encyclopedia

  https://embryo.asu.edu/pages/neonatal-respiratory-distress-syndrome-and-its-treatment-artificial-surfactant

  Once physicians diagnose an infant with respiratory distress syndrome, they can treat the infant by administering artificial surfactant. […] Physicians use two strategies for administering surfactant. First, using a preventative strategy, physicians administer artificial surfactant to premature infants who are at risk for developing respiratory distress. […] In 2009, Roger Soll and Eren zek conducted a meta-analysis that showed that multiple doses of artificial surfactant lowered the risk of complications and death associated with a single dose of surfactant. […] However, the mortality rate of neonatal respiratory distress syndrome has decreased due to surfactant replacement therapy.

• #22 Surfactant preparations for preterm infants with respiratory distress syndrome: past, present, and future

  https://www.e-cep.org/journal/view.php?doi=10.3345/kjp.2018.07185

  Following the first successful trial of surfactant replacement therapy for preterm infants with respiratory distress syndrome (RDS) by Fujiwara in 1980, several animal-derived natural surfactants and synthetic surfactants have been developed. […] The more important thing than the composition of the surfactant in improving outcome is the timing and mode of administration of the surfactant. […] Improvement of treatment modalities with less-invasive or noninvasive methods of surfactant administration will be the most important task to be resolved. […] As of January 2011, surfactant has been administered as prophylactic therapy in infants born at 30 weeks gestation or with a birth body weight 1,250 g within 2 hours after birth, according to notification No. 2010-135 from the Ministry of Health and Welfare on January 2011.

• #23 Surfactant preparations for preterm infants with respiratory distress syndrome: past, present, and future

  https://www.e-cep.org/journal/view.php?doi=10.3345/kjp.2018.07185

  It has been reported that the timing of administration of the surfactant, such as prophylactic versus rescue and early (within 2 hours after birth) versus delayed (later than 2 hours after birth) treatment, is more important than the composition of the surfactant preparations themselves. […] A noninvasive ventilator may improve the pulmonary outcome of preterm infants. […] New modes of surfactant administration such as Minimally-Invasive Surfactant Therapy, Non-Invasive Surfactant Therapy, and aerosolized delivery of surfactants have been developed to reduce the risks associated with endotracheal tube placement. […] Improvement in treatment modality by applying a less invasive or a noninvasive method of surfactant administration will be the most important task to be resolved in the near future.

• #24 Surfactant replacement therapy for respiratory distress syndrome in preterm infants: United Kingdom national consensus | Pediatric Research

  https://www.nature.com/articles/s41390-019-0344-5

  1. All neonatal units should have an agreed policy for the management of early RDS. […] […] 2. Early rescue surfactant rather than prophylaxis is recommended. In some situations, this may include surfactant administration in the delivery suite. […] […] […] 3. In babies with evolving RDS, rescue surfactant should be administered early in the course of the disease. Inspired oxygen concentration above 30% in the first hours of life is a reasonable predictor of CPAP failure. […] […] […] 5. There is emerging evidence that the LISA technique may be the preferred method for spontaneously breathing preterm infants kept on NIV, as an alternative to the intubation-surfactant-extubation (INSURE) technique.

• #25 Respiratory Distress Syndrome: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/976034-overview

  Enormous strides have been made in understanding the pathophysiology and management of respiratory distress syndrome, leading to improvements in morbidity and mortality in infants with the condition. […] The use of antenatal steroids to enhance pulmonary maturity. […] Appropriate resuscitation facilitated by placental transfusion and immediate use of continuous positive airway pressure (CPAP) for alveolar recruitment. […] Early administration of surfactant. […] The use of gentler modes of ventilation, including early use of „bubble” nasal CPAP to minimize damage to the immature lungs. […] Supportive therapies, such as the diagnosis and management of patent ductus arteriosus (PDA), fluid and electrolyte management, trophic feeding and nutrition, and the use of prophylactic fluconazole.

• #26 Respiratory Distress Syndrome: Background, Etiology, Epidemiology

  https://emedicine.medscape.com/article/976034-overview

  Strategic goals include focusing direct attention on anticipating and minimizing these complications and preventing premature delivery whenever possible. […] Use of antenatal steroids has decreased the frequency of intracranial hemorrhage in these patients with respiratory distress syndrome. […] Some neonatal ICUs use prophylactic fluconazole in the extremely premature infants, achieving a decrease in the incidence of candidal septicemia. […] Postnatal use of surfactant therapy, gentler ventilation, vitamin A, low-dose steroids, and inhaled nitric oxide may reduce the severity of BPD.

• #27 Management of Respiratory Distress Syndrome – ESCNH – European Standards of Care for Newborn Health

  https://newborn-health-standards.org/standards/standards-english/medical-care-clinical-practice/management-of-respiratory-distress-syndrome/

  Newborn infants at risk of Respiratory Distress Syndrome (RDS) receive appropriate perinatal care including place of delivery, antenatal corticosteroids, guidance around optimal strategies for delivery room stabilisation, and ongoing respiratory support. […] The goal is to promote optimum survival without complications for newborn infants at risk of Respiratory Distress Syndrome (RDS), whilst minimising potential risks of adverse effects such as pulmonary air leak and bronchopulmonary dysplasia. […] With implementation of regional training for standards such as less invasive surfactant administration it is possible at country-wide level to improve quality of care. […] Ensure all healthcare professionals involved in neonatal care are trained in the use of all modes of respiratory support including volume-targeted modes of synchronised ventilation, high frequency oscillation, nasal ventilation, CPAP, heated humidified high flow oxygen and blended oxygen.

• #28 Management of Respiratory Distress Syndrome – ESCNH – European Standards of Care for Newborn Health

  https://newborn-health-standards.org/standards/standards-english/medical-care-clinical-practice/management-of-respiratory-distress-syndrome/

  A unit guideline to ensure a standardised approach to initial stabilisation after birth for newborn infants at risk of RDS is available and regularly updated, including access to blended oxygen, access to CPAP from birth, access to manual ventilation with devices that control pressures, access to pulse oximetry from birth. […] A unit guideline is available and regularly updated including surfactant administration, criteria for intubation, and ventilation strategies with optimal lung protection. […] Training on management of RDS is ensured. […] Women at risk for very preterm birth are referred in a timely fashion for expert care during pregnancy and delivery.

• #29 (PDF) Prevention of Neonatal Respiratory Distress Syndrome

  https://www.academia.edu/102822690/Prevention_of_Neonatal_Respiratory_Distress_Syndrome

  Respiratory distress syndrome (RDS) is one of the most frequent respiratory diseases and is a leading cause of neonatal morbidity and mortality. […] Prenatal diagnosis to identify children at risk, prevention of disease by antenatal administration of glucocorticoids, improving perinatal and neonatal care, advances in respiratory support and surfactant administration, have reduced mortality associated with respiratory distress syndrome. […] Recent improvements such as antenatal steroid treatment to enhance pulmonary maturity, appropriate resuscitation facilitated by placental transfusion and immediate use of continuous positive airway pressure for alveolar recruitment, early rescue administration of surfactant, ventilation with gentler modes to minimize damage to the immature lungs, and the other supportive therapies have significantly decreased respiratory distress syndrome-related morbidity and mortality.

• #30 (PDF) Prevention of Neonatal Respiratory Distress Syndrome

  https://www.academia.edu/102822690/Prevention_of_Neonatal_Respiratory_Distress_Syndrome

  Surfactant replacement was established as an effective and safe therapy for immaturity-related surfactant deficiency by the early 1990s. […] Antenatal steroid use to stimulate structural maturation and surfactant synthesis in the fetal lung increased significantly after completion of the pivotal surfactant trials. […] The purpose of this clinical report is to update and expand our previous statement about surfactant replacement in newborn infants. […] With a randomized clinical trial, the possibility was assessed that a tracheal instillation of pulmonary surfactant prior to the first breath might prevent the development of some of the signs of neonatal respiratory distress syndrome. […] It is concluded that surfactant supplementation prior to the first breath is feasible and is of value as protection against the respiratory distress syndrome and the negative effects of hypoxia and ventilatory support. […] The results obtained show that the incidence of HMD in preterm infants is mediated by the early gestational age and advanced age of the mother, and decreased by corticosteroid therapy.

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