Surfactant, mechanical

At present, exogenous surfactant replacement therapy and mechanical ventilation (MV) remain the ‘Standard of Care’ while treating such infants. However, this requires endotracheal intubation – an invasive procedure associated with complications. Moreover, the skills required to intubate very small babies are not universally available and may vary among the healthcare professionals even in developed countries. A combination of these factors have now motivated professionals caring for such babies to use non-invasive forms of respiratory support which do not require placement of an endotracheal tube. Although appearing to be simple to use, scientific evidence for the efficacy and safety of individual techniques may not yet be fully established and users should be aware of their limitations. These non-invasive respiratory support methods include: ■ Continuous positive airway pressure (CPAP) ■ Nasal intermittent positive pressure ventilation (IPPV) ■ High flow nasal cannula (HFNC).