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Published on: December 5, 2025

Initial respiratory support of preterm infants: the role of CPAP, the INSURE method, and noninvasive ventilation

Robert H Pfister1, Roger F Soll

  • 1Department of Pediatrics, University of Vermont, FAHC-Smith 556, Burlington, VT 05401, USA. Robert.Pfister@vtmednet.org

Clinics in Perinatology
|September 8, 2012
PubMed

Insights

This review examines continuous positive airway pressure (CPAP) and surfactant strategies for preterm infant respiratory support. Evidence from randomized trials guides optimal initial respiratory management for neonates.

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Care
  • Perinatal Research

Background:

  • Preterm infants frequently experience respiratory distress.
  • Effective initial respiratory management is crucial for neonatal outcomes.
  • Current strategies aim to minimize lung injury and support breathing.

Purpose of the Study:

  • To review evidence on initial respiratory management strategies for preterm infants.
  • To compare the benefits and risks of different approaches.
  • To inform clinical practice regarding delivery room and early hospital respiratory support.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) and meta-analyses.
  • Focus on continuous positive airway pressure (CPAP) initiated early.
  • Evaluation of blended strategies: early surfactant followed by CPAP.

Main Results:

  • Continuous positive airway pressure (CPAP) initiated in the delivery room shows promise.
  • Blended strategies involving early surfactant and CPAP stabilization are increasingly utilized.
  • Evidence synthesis guides the selection of optimal respiratory support.

Conclusions:

  • Early respiratory support strategies significantly impact preterm infant outcomes.
  • Continuous positive airway pressure (CPAP) and surfactant administration are key interventions.
  • Evidence-based approaches are essential for neonatal respiratory care.

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