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Current Controversies and Advances in Non-invasive Respiratory Support for Preterm Infants

  • Pediatric Neonatology (T Thorkelsson, Section Editor)
  • Published:
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Abstract

Purpose of Review

Advances in neonatal respiratory support have resulted in increasing survival of infants at the limits of viability. This has resulted in substantial change in the typical patient population in neonatal intensive care units as well as availability of newer respiratory strategies. This review aims to highlight the evidence base behind some of these advancements and resultant controversies.

Recent Findings

Non-invasive respiratory support has been shown to improve short-term respiratory outcome but the impact on long-term respiratory health needs more evidence. There is no clear evidence that one mode of continuous positive airway pressure delivery is superior to others. Newer methods of non-invasive respiratory support are increasingly being used without clear evidence of benefit on meaningful clinical outcomes. There is increasing evidence for less invasive methods of surfactant administration as viable alternatives to conventional methods.

Summary

While innovations in neonatal respiratory support have contributed to improved survival and reducing lung injury in preterm infants, some fundamental questions for optimizing respiratory care still remain. In addition, these have brought new challenges such as redefining respiratory morbidities to better reflect contemporary clinical practice, or finding a balance between evidence-based medicine and incorporation of newer practices.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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  1. Division of Neonatology, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Medical Education Building–Room: 312D, 1 Robert Wood Johnson Place, New Brunswick, NJ, 08901, USA

    Deepak Jain MD & Manan Shah MD

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Jain, D., Shah, M. Current Controversies and Advances in Non-invasive Respiratory Support for Preterm Infants. Curr Treat Options Peds 8, 262–277 (2022). https://doi.org/10.1007/s40746-022-00239-w

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