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The evolution of modern respiratory care for preterm infants

Louise S Owen1, Brett J Manley2, Peter G Davis1

  • 1Neonatal Services, The Royal Women's Hospital, Melbourne, VIC, Australia; Newborn Research Centre, The Royal Women's Hospital, Melbourne, VIC, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, VIC, Australia.

Lancet (London, England)
|April 27, 2017
PubMed

Insights

Rising preterm birth rates necessitate improved neonatal respiratory care. Current treatments like oxygen therapy and surfactant have benefits but require further research to optimize outcomes and prevent lung damage, particularly in high-risk infants.

Area of Science:

  • Neonatal Medicine
  • Respiratory Care
  • Pediatric Pulmonology

Background:

  • Preterm birth rates are increasing globally, leading to a higher incidence of respiratory distress in newborns.
  • Established treatments for neonatal respiratory issues include oxygen therapy, exogenous surfactant, respiratory support, and postnatal corticosteroids.
  • Bronchopulmonary dysplasia (BPD) remains a significant challenge in neonatal care despite advances.

Purpose of the Study:

  • To review the historical evolution of neonatal respiratory care.
  • To analyze the impact of current treatments on long-term infant outcomes.
  • To identify future research directions in neonatal respiratory support.

Main Methods:

  • Review of historical data and current literature on neonatal respiratory care.
  • Analysis of the efficacy and controversies surrounding oxygen therapy, surfactant replacement, respiratory support modalities, and corticosteroids.
  • Discussion of the challenges in managing bronchopulmonary dysplasia.

Main Results:

  • Oxygen therapy delivery and monitoring remain debated despite decades of use.
  • Exogenous surfactant has significantly reduced mortality but requires further research on optimal administration.
  • Non-invasive respiratory support is gaining traction over routine intubation and ventilation.

Conclusions:

  • Optimizing neonatal respiratory support is crucial for preterm infants, especially those at high risk for BPD.
  • Further research is needed to refine the use of existing therapies and develop new strategies.
  • The goal is to support infant breathing without causing lung damage or long-term adverse health effects.

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