Introduction: Respiratory distress syndrome (RDS) remains an important problem following premature birth. Those born extremely prematurely can suffer mortality and serious morbidity. Identifying effective treatments and respiratory support modes is essential.

Areas covered: Current treatments and modes of respiratory support have been examined, as well as the evidence base for new therapies and respiratory modes. A literature search was undertaken using PubMed and Google Scholar.

Expert opinion: It is now common practice to stabilise infants on non-invasive respiratory support in the delivery suite and give early selective surfactant to infants with RDS. Increasingly, less invasive surfactant administration is used. Systemically administered corticosteroids should not be given in the perinatal period; inhaled budesonide has been associated with an increased mortality. Inhaled nitric oxide can be helpful in preterm infants with pulmonary hypertension. Caffeine should be routinely administered. Further research regarding the safety and efficacy of stems cells is required. Post extubation, nasal intermittent positive pressure ventilation (NIPPV) rather than nasal continuous positive airway pressure (nCPAP) provides better support and humidified high flow nasal cannula (HHFNC) has similar efficacy to continuous positive airway pressure (CPAP). Volume targeting should be used for infants requiring intubation and high frequency oscillation reserved for severe RDS. There is insufficient evidence to determine the role of proportional assist ventilation and neurally adjusted ventilatory assist. Whether closed loop automatic oxygen control improves long term outcomes needs testing.

简介：呼吸窘迫综合征（RDS）仍然是早产后的重要问题。那些过早出生的人会遭受死亡和严重的发病。确定有效的治疗方法和呼吸支持模式至关重要。

涵盖的领域：已经检查了当前的治疗方法和呼吸支持方式，以及新疗法和呼吸方式的证据基础。使用PubMed和Google Scholar进行文献检索。

专家意见：现在的惯例是在分娩套件中稳定婴儿的无创呼吸支持，并为RDS婴儿提供早期选择性表面活性剂。越来越多地使用侵入性较小的表面活性剂给药。围产期不应给予全身性激素治疗；吸入布地奈德会增加死亡率。吸入一氧化氮可能对患有肺动脉高压的早产儿有所帮助。咖啡因应常规使用。有关干细胞安全性和功效的进一步研究是必需的。拔管后 鼻间歇正压通气（NIPPV）而非鼻持续气道正压（nCPAP）提供了更好的支持，加湿的高流量鼻导管（HHFNC）与持续气道正压（CPAP）具有相似的功效。体积靶向应用于需要插管和为严重RDS保留的高频振荡的婴儿。没有足够的证据确定比例辅助通气和神经调节通气辅助的作用。闭环自动氧气控制能否改善长期效果还需要测试。