Improving Neonatal Transition by Giving Ventilatory Support in the Delivery Room

Abstract

Extremely low gestational age neonates are likely to require help with breathing. Strategies to enhance uncomplicated pulmonary transition are critically evaluated in this article. These strategies include antenatal corticosteroid treatment and different respiratory support options immediately after birth. Important techniques for providing early neonatal support include the careful monitoring of the postnatal progression of heart rate and oxygenation in the delivery room, the provision of continuous distending positive airway pressure with avoidance of high tidal volumes, surfactant treatment without intubation, and options for avoiding endotracheal intubation by giving nasal continuous positive airway pressure from birth. We discuss how the less invasive strategies are likely to reduce iatrogenic neonatal lung injury and may indeed help to reduce the incidence of bronchopulmonary dysplasia.