A 1.5 kg child born at 32 weeks by LSCS presents with moderate respiratory difficulty (RR 70/ minutes). Which of the following is the appropriate management –
(A) CPAP (B) Mechanical ventilation (C) Warm oxygen (D) Surfactant and ventilation
(A) Specific treatment for HMD is intratracheal surfactant therapy. This therapy requires endotracheal intubation, which also may be necessary to achieve adequate ventilation and oxygenation.
Less premature infants (those > 1 kg or > 28-30 weeks gestation) and those with lower 02 requirements (Fi02 < 40 - 50%) may respond well to supplemental 02 alone or to treatment with nasal continuous positive airway pressure (CPAP).