Abstract
Although surfactant is the most studied drug in the preterm infant, the best criteria
for treatment of preterm infants with respiratory distress syndrome (RDS) with surfactant
have been not extensively investigated. We assessed the criteria used for deciding
the rescue surfactant treatment of preterm infants with RDS in combination with nasal
continuous positive airway pressure as reported by the main recent randomized controlled
trials. We evaluated 10 studies and found that the criteria chosen for administering
selective surfactant were very heterogeneous, different types and doses of surfactant
were used, and this limits their applicability in the clinical practice. In conclusion,
although current data seem to suggest that low threshold is better than high threshold,
additional studies are necessary to identify the most effective criteria for selective
surfactant treatment of preterm infants with RDS.
Keywords
INSURE - failure - surfactant - NCPAP - preterm infant - threshold - respiratory distress
syndrome