Changing trends in the management of respiratory distress syndrome (RDS).
The management of respiratory distress syndrome (RDS) has advanced because of improvements in mechanical ventilators, promotion of antenatal steroids, availability of surfactant and overall advancements in neonatal intensive care. Intermittent mandatory ventilation still forms the mainstay of assisted ventilation. Newer modes of ventilation have not delivered the results as promised. Because of the continued high incidence of bronchopulmonary dysplasia, there is a renewed interest in non-invasive modes of ventilation like CPAP and nasal IPPV. The present trend is to follow gentle ventilatory strategies accepting higher arterial carbon dioxide and lower oxygen. The role of antenatal steroids has been established beyond doubt but still they fall short of universal acceptance. Surfactant replacement therapy is the standard of care for RDS but beyond the reach of majority in India. Postnatal steroids are out of vogue because of probable links with cerebral palsy and abnormal neurological outcomes.
Kumar
Praveen
P
Neonatal Unit, Department of Pediatrics, Post-Graduate Institute of Medical Education & Research, Chandigarh, India.
Kiran
P S Sandesh
PS
D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control*; D003131:Combined Modality Therapy / Q000592:standards* / Q000639:trends; D003422:Critical Care / Q000379:methods; D005260:Female; D006801:Humans; D007194:India; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D010102:Oxygen Inhalation Therapy; D011175:Positive-Pressure Respiration / Q000379:methods; D011247:Pregnancy; D011295:Prenatal Care; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013256:Steroids / Q000627:therapeutic use; D016019:Survival Analysis; D016896:Treatment Outcome
D011663:Pulmonary Surfactants; D013256:Steroids