Tip 47: PEEP from the first breath

Studies have shown a ~50% reduction in surfactant administration in 25-28 week gestation babies who receive early PEEP during resuscitation/stabilisation. Also, less supplemental oxygen is required. However, the risk of pneumothorax is increased and there is no overall reduction in mortality or chronic lung disease (CLD).

References:

Sweet, D.G., Carnielli, V., Greisen, G., et al., 2013. European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants – 2013 Update. Neonatology; 103:353-368. DOI: 10.1159/000349928.

Morley, C.J., et al. Nasal CPAP or intubation at birth for very preterm infants. N Engl J Med; 358(7): 700-8. DOI: 10.1056/NEJMoa072788. RCT, 610 infants.

First published: 14/02/14

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