A 1.5 kg child born at 32 weeks by LSCS presents with moderate respiratory difficulty (RR: 70/min, Spo2: 92%). Which is the next best step?
Ans. B. CPAPThe most common cause of respiratory distress in a preterm infant is neonatal RDS/hyaline membrane disease.The infant has presented with moderate respiratory distress without any signs of respiratory failure so early continuous positive airway pressure (CPAP) is the appropriate treatment.CPAP started at birth is the choice for the management of a preterm infant at risk for respiratory distress syndrome (RDS). Early nasal CPAP has shown to lower mortality and risk of bronchopulmonary dysplasia.Air is better than oxygen for the resuscitation of preterm infants, and 100% oxygen is also harmful, causing increased oxidative stress.The intubate-surfactant-extubate (INSURE) on CPAP technique is recommended for surfactant administration when babies showed signs of RDS and needed more than 30% inspired oxygen to maintain saturation in the normal range.
Mechanical ventilation
CPAP
100% oxygen
Surfactant and ventilation
New Born Infants