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).


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.

Previously published: 14/02/14, 19/11/14

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