Abstract

Very preterm infants often require some form of respiratory support to facilitate the cardiopulmonary transition that occurs in the first hours of life. Current resuscitation guidelines identify that the primary determinant of overall neonatal survival is establishing adequate lung inflation and ventilation immediately after birth to ensure adequate functional residual capacity. However, the respiratory assistance provided is an important factor contributing to the development of bronchopulmonary dysplasia. Conversely, the risks associated with invasive mechanical ventilation increase with gestational age. Premature infants are born with early lung development and are more susceptible to lung damage from mechanical ventilation. Approaches aimed at reducing the global burden of early lung disease should implement lung-protective ventilation strategies beginning with the newborn’s first breath in the delivery room. Neonatologists today must be able to administer both invasive and non-invasive respiratory support to treat a variety of lung conditions ranging from acute to chronic conditions. You searched PubMed for articles on respiratory support for preterm infants. Our narrative review provides an evidence-based overview of respiratory management in preterm infants, specifically delivery room-to-NICU respiratory management in the acute phase of neonatal respiratory distress syndrome, and includes a section on exogenous surfactant therapy.