title: European consensus guidelines on the management of neonatal respiratory distress syndrome.
abstract: Despite recent advances in the perinatal management of neonatal respiratory distress syndrome (RDS), controversies still exist. We report the recommendations of a European panel of expert neonatologists who developed consensus guidelines after critical examination of the most up-to-date evidence in 2007. Strong evidence exists for the role of antenatal steroids in RDS prevention, but it is not clear if repeated courses are safe. Many practices involved in preterm neonatal stabilization at birth are not evidence based, including oxygen administration and positive pressure lung inflation, and they may at times be harmful. Surfactant replacement therapy is crucial in management of RDS but the best preparation, optimal dose and timing of administration at different gestations is not always clear. Respiratory support in the form of mechanical ventilation may also be life saving but can cause lung injury, and protocols should be directed to avoiding mechanical ventilation where possible by using nasal continuous positive airways pressure. For babies with RDS to have the best outcome, it is essential that they have optimal supportive care, including maintenance of a normal body temperature, proper fluid management, good nutritional support, management of the ductus arteriosus and support of the circulation to maintain adequate blood pressure.
authors.affiliation: Regional Neonatal Unit, Royal Maternity Hospital, Belfast, Northern Ireland, UK. david.sweet@royalhospitals.n-i.nhs.uk
authors.forename: David
authors.initials: D
authors.lastname: Sweet
authors.forename: Giulio
authors.initials: G
authors.lastname: Bevilacqua
authors.forename: Virgilio
authors.initials: V
authors.lastname: Carnielli
authors.forename: Gorm
authors.initials: G
authors.lastname: Greisen
authors.forename: Richard
authors.initials: R
authors.lastname: Plavka
authors.forename: Ola Didrik
authors.initials: OD
authors.lastname: Saugstad
authors.forename: Umberto
authors.initials: U
authors.lastname: Simeoni
authors.forename: Christian P
authors.initials: CP
authors.lastname: Speer
authors.forename: Adolf
authors.initials: A
authors.lastname: Valls-I-Soler
authors.forename: Henry
authors.initials: H
authors.lastname: Halliday
mesh_terms: D004750:Enteral Nutrition; D005060:Europe; D006801:Humans; D007231:Infant, Newborn; D010102:Oxygen Inhalation Therapy; D011295:Prenatal Care; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy; D013501:Surface-Active Agents / Q000008:administration & dosage
chemical_list: D013501:Surface-Active Agents