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Licensed Unlicensed Requires Authentication Published by De Gruyter May 4, 2007

European consensus guidelines on the management of neonatal respiratory distress syndrome

  • David Sweet , Giulio Bevilacqua , Virgilio Carnielli , Gorm Greisen , Richard Plavka , Ola Didrik Saugstad , Umberto Simeoni , Christian P. Speer , Adolf Valls-i-Soler and Henry Halliday

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.


Corresponding author: Dr. David Sweet, MD, FRCPCH Regional Neonatal Unit Royal Maternity Hospital Belfast BT12 6BB Northern Ireland UK

Published Online: 2007-05-04
Published in Print: 2007-6-1

©2007 by Walter de Gruyter Berlin New York

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