Traditional treatment of respiratory distress syndrome in preterm infants consisted of early intubation, mechanical ventilation and intra-tracheal administration of exogenous surfactant. Recently, non-invasive ventilation, which has shown some advantages in short- and long-term outcomes, has gained popularity for the initial management of respiratory insufficiency in preterm infants. However, non-invasive ventilation from the outset poses difficulties in relation to administration of exogenous surfactant. The customary INSURE technique requires tracheal intubation, surfactant administration, and rapid extubation, but the latter is not always possible. As a more elegant approach, several minimally invasive techniques of delivering surfactant have been developed for babies spontaneously breathing on CPAP. The most extensively studied have been those in which the trachea is briefly catheterized with a nasogastric tube or vascular catheter, and exogenous surfactant is administered. Although results seem promising they are not yet conclusive, and further studies will be needed to answer a number of outstanding questions.

Item Type:	Refereed Article
Keywords:	Infant, preterm, Respiratory distress, Non-invasive ventilation, Pulmonary surfactants, Gentle approach
Research Division:	Medical and Health Sciences
Research Group:	Paediatrics and Reproductive Medicine
Research Field:	Paediatrics
Objective Division:	Health
Objective Group:	Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:	Respiratory System and Diseases (incl. Asthma)
UTAS Author:	Dargaville, PA (Professor Peter Dargaville)
ID Code:	99056
Year Published:	2014
Web of Science® Times Cited:	5
Deposited By:	Menzies Institute for Medical Research
Deposited On:	2015-03-12
Last Modified:	2017-11-06
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