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Optimal Ventilation and Surfactant Therapy in Very-Low-Birth-Weight Infants in Resource-Restricted Regions

Lizelle Van Wyk1, Lloyd Tooke2, Ricky Dippenaar3

  • 1Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa, lizelle@sun.ac.za.

Neonatology
|May 27, 2020
PubMed

Insights

Respiratory distress syndrome (RDS) management, including nasal CPAP and surfactant therapy, is crucial for reducing infant mortality in resource-restricted areas. Implementing these strategies, alongside improved antenatal care, can significantly decrease premature infant deaths.

Area of Science:

  • Neonatal Medicine
  • Public Health
  • Pediatrics

Background:

  • Respiratory distress syndrome (RDS) data are underreported in resource-restricted regions, hindering effective intervention assessment.
  • Limited data complicates the evaluation of interventions and outcomes for neonatal respiratory distress.
  • Sub-Saharan Africa faces significant challenges in managing RDS in premature infants.

Purpose of the Study:

  • To provide an overview of RDS management strategies in resource-restricted settings, focusing on nasal CPAP and surfactant therapy.
  • To evaluate the feasibility and impact of RDS management in a resource-restricted region using data from the Western Cape, South Africa.
  • To highlight the potential of combined therapies to reduce RDS-related mortality.

Main Methods:

  • Review of current RDS management practices in resource-restricted areas, particularly in sub-Saharan Africa.
  • Analysis of data from the public and private health sectors in the Western Cape, South Africa, to illustrate management capabilities.
  • Focus on the application of nasal continuous positive airway pressure (CPAP) and surfactant therapy for very-low-birth-weight infants.

Main Results:

  • The combination of oxygen, nasal CPAP, and surfactant therapy shows potential to prevent 42% of RDS-related deaths in sub-Saharan Africa.
  • RDS management strategies can achieve significant outcomes even in resource-restricted environments, as demonstrated by Western Cape data.
  • Integrated approaches encompassing antenatal care, corticosteroids, and hypothermia prevention are vital.

Conclusions:

  • Effective RDS management, including nasal CPAP and surfactant therapy, is critical for reducing premature infant mortality in resource-limited settings.
  • Upscaling comprehensive care components, from antenatal services to neonatal interventions, is necessary for substantial improvements.
  • Financial implications of advanced therapies must be considered alongside their life-saving potential.

Keywords:
Continuous positive airway pressureResource-restricted regionsSurfactant therapyVery low birth weight

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