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Updated: May 24, 2026

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)
06:22

Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome (ARDS)

Published on: April 7, 2021

RDS--CPAP or surfactant or both

Kajsa Bohlin1

  • 1Department of Neonatology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden. kajsa.bohlin@ki.se

Acta Paediatrica (Oslo, Norway : 1992)
|March 13, 2012
PubMed

Insights

Early continuous positive airway pressure (CPAP) is safe for preterm infants. A surfactant strategy is crucial for those at risk of respiratory distress syndrome (RDS) when using non-invasive ventilation.

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Care

Background:

  • Early continuous positive airway pressure (CPAP) is increasingly recognized as a safe and feasible intervention for very preterm infants.
  • Respiratory distress syndrome (RDS) remains a significant concern, often necessitating surfactant treatment even with early CPAP.
  • Optimizing surfactant administration alongside non-invasive ventilation is critical but requires further investigation.

Purpose of the Study:

  • To evaluate the safety and efficacy of early CPAP in very preterm neonates.
  • To explore strategies for surfactant administration within a non-invasive ventilation approach.
  • To identify optimal methods for surfactant delivery and the utility of predictive tests for surfactant deficiency.

Main Methods:

  • Review of current evidence on early CPAP in very preterm infants.
  • Analysis of strategies for surfactant administration in conjunction with non-invasive ventilation.
  • Discussion of optimal timing, delivery modes, and predictive testing for surfactant deficiency.

Main Results:

  • Early CPAP demonstrates comparable safety to routine intubation in the delivery room for very preterm infants.
  • A significant proportion of infants receiving early CPAP still require surfactant treatment for RDS.
  • The optimal approach involves integrating surfactant administration into non-invasive ventilation strategies for high-risk infants.

Conclusions:

  • Early CPAP is a safe alternative to delivery room intubation for very preterm neonates.
  • A proactive strategy for surfactant administration is essential for infants at risk of significant RDS when utilizing non-invasive ventilation.
  • Further research is needed to refine surfactant administration protocols and predictive testing.
Abstract

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