Early respiratory support for very preterm infant to prevent bronchopulmonary dysplasia / 中国小儿急救医学

ABSTRACT

Although respiratory distress syndrome( RDS) ,one of the most common cause of respira-tory failure in the very or extremely preterm infant,has not been yet the major disorder of death with advances of respiratory support;In fact,RDS often complicated with BPD which developed with the maturation of de-pendence,the outcome of BPD and its development step into the focus of modern NICU. Powerful evidence-based consensus and suggestions have been stated in early respiratory support for very and extremely preterm infantEarly nasal CPAP( nCPAP) should be the best alternative to intubation for very or extremely preterm infant with high-risk of RDS and RDS; Early administration of Pulmonary surfactant ( PS ) with suitable methods( InSurE,Intubation Surfactant Extubation or LISA,Less invasive surfactant administration);Individ-ual threshould for nCPAP or other noninvasive ventilation failure should be established,but early PS adminis-tration and gentle ventilation will decrease the incidence of ventilator-induced injury on failuring noninvasive ventilation;Noninvasive ventilation with the use of caffeine will short the duration of ventilation and improve the success of weaning off. All the strategies in respiratory support to prevent BPD for very preterm infant still need more practice sustain improvement since multiple causes account for the development of BPD.