A premature baby weighing 1.5 kg, born with emergency C.S. at 32 weeks, now develops respiratory distress with grunting. The best management would be:
Premature infants with respiratory distress syndrome present with progressively worsening retractions, tachypnea, and oxygen requirements because their lungs are too immature to synthesize surfactant. This disease has a characteristic radiographic pattern that includes "ground glass" opacities in the lung parenchyma and prominent air bronchograms. Initial therapy for respiratory distress syndrome involves using CPAP to stent open the airways, thereby reducing the collapse of the alveoli and limiting fuher damage. For intubated infants with respiratory distress syndrome, the second intervention involves surfactant administration through the ET tube. This procedure can result in rapid changes in pulmonary compliance. Ref: Wood K.S., Gordon P.V. (2011). Chapter 4. Neonatal and Pediatric Transpo. In J.E. Tintinalli, J.S. Stapczynski, D.M. Cline, O.J. Ma, R.K. Cydulka, G.D. Meckler (Eds), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e.
C-pap
Mechanical ventilation
Moist oxygen through headbox
Surfactant therapy plus mechanical ventilation