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Current trials in the treatment of respiratory failure in preterm infants

Roger F Soll1

  • 1Department of Pediatrics, University of Vermont College of Medicine, Burlington, VT 05401, USA. Roger.Soll@vtmednet.org

Neonatology
|June 5, 2009
PubMed

Insights

Improvements in extremely low-birth-weight infant care plateaued in the early 21st century. Future progress may stem from refining existing methods like less invasive respiratory support and combining therapies such as continuous positive airway pressure and surfactant.

Area of Science:

  • Neonatal Medicine
  • Pediatric Critical Care
  • Respiratory Physiology

Background:

  • Significant improvements in extremely low-birth-weight (ELBW) infant outcomes were observed at the end of the 20th century.
  • Advances included antenatal corticosteroids and postnatal surfactant therapy for respiratory distress syndrome (RDS).

Purpose of the Study:

  • To evaluate progress in improving clinical outcomes for ELBW infants in the first decade of the 21st century.
  • To identify potential future strategies for enhancing ELBW infant care.

Main Methods:

  • Review of clinical outcomes and therapeutic interventions for ELBW infants.
  • Analysis of the impact of newer ventilation modes and inhaled nitric oxide.
  • Assessment of the potential of refining current therapies.

Main Results:

  • Limited progress in improving ELBW infant outcomes has been made in the early 21st century.
  • Newer ventilation techniques and inhaled nitric oxide have shown minimal demonstrable benefits.
  • Refinement of existing supportive care shows promise.

Conclusions:

  • Current advancements in respiratory support for ELBW infants have yielded diminishing returns.
  • Optimizing current therapies, including less invasive respiratory support and combining treatments like continuous positive airway pressure (CPAP) and surfactant, may offer the greatest potential for improving ELBW infant survival and health.
  • Further research into the synergistic effects of combined therapies is warranted.

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