European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2016 Update

TY - JOUR

T1 - European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2016 Update

AU - Sweet, David G

AU - Carnielli, Virgilio

AU - Greisen, Gorm

AU - Hallman, Mikko

AU - Ozek, Eren

AU - Plavka, Richard

AU - Saugstad, Ola Didrik

AU - Simeoni, Umberto

AU - Speer, Christian P

AU - Vento, Máximo

AU - Visser, Gerard H A

AU - Halliday, Henry L

N1 - © 2016 S. Karger AG, Basel.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Advances in the management of respiratory distress syndrome (RDS) ensure that clinicians must continue to revise current practice. We report the third update of the European Guidelines for the Management of RDS by a European panel of expert neonatologists including input from an expert perinatal obstetrician based on available literature up to the beginning of 2016. Optimizing the outcome for babies with RDS includes consideration of when to use antenatal steroids, and good obstetric practice includes methods of predicting the risk of preterm delivery and also consideration of whether transfer to a perinatal centre is necessary and safe. Methods for optimal delivery room management have become more evidence based, and protocols for lung protection, including initiation of continuous positive airway pressure and titration of oxygen, should be implemented from soon after birth. Surfactant replacement therapy is a crucial part of the management of RDS, and newer protocols for surfactant administration are aimed at avoiding exposure to mechanical ventilation, and there is more evidence of differences among various surfactants in clinical use. Newer methods of maintaining babies on non-invasive respiratory support have been developed and offer potential for greater comfort and less chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease although minimizing the time spent on mechanical ventilation using caffeine and if necessary postnatal steroids are also important considerations. Protocols for optimizing the general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome.

AB - Advances in the management of respiratory distress syndrome (RDS) ensure that clinicians must continue to revise current practice. We report the third update of the European Guidelines for the Management of RDS by a European panel of expert neonatologists including input from an expert perinatal obstetrician based on available literature up to the beginning of 2016. Optimizing the outcome for babies with RDS includes consideration of when to use antenatal steroids, and good obstetric practice includes methods of predicting the risk of preterm delivery and also consideration of whether transfer to a perinatal centre is necessary and safe. Methods for optimal delivery room management have become more evidence based, and protocols for lung protection, including initiation of continuous positive airway pressure and titration of oxygen, should be implemented from soon after birth. Surfactant replacement therapy is a crucial part of the management of RDS, and newer protocols for surfactant administration are aimed at avoiding exposure to mechanical ventilation, and there is more evidence of differences among various surfactants in clinical use. Newer methods of maintaining babies on non-invasive respiratory support have been developed and offer potential for greater comfort and less chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease although minimizing the time spent on mechanical ventilation using caffeine and if necessary postnatal steroids are also important considerations. Protocols for optimizing the general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome.

KW - Consensus

KW - Continuous Positive Airway Pressure/methods

KW - Disease Management

KW - Europe

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Infant, Premature

KW - Neonatologists

KW - Pulmonary Surfactants/therapeutic use

KW - Respiratory Distress Syndrome, Newborn/therapy

U2 - 10.1159/000448985

DO - 10.1159/000448985

M3 - Journal article

C2 - 27649091

SN - 1661-7800

VL - 111

SP - 107

EP - 125

JO - Neonatology

JF - Neonatology

ER -