# Early continuous positive airway pressure versus surfactant therapy in preterm neonates with respiratory distress

## TL;DR

This study compares early CPAP and surfactant therapy in preterm neonates with respiratory distress, finding that each treatment is most effective in specific gestational age groups.

## Contribution

The study identifies optimal treatment strategies for preterm neonates based on gestational age, offering guidance for resource-limited settings.

## Key findings

- Early CPAP alone achieves high survival rates in 31-36-week preterm neonates.
- Extremely preterm neonates (27-30 weeks) benefit more from combined CPAP-surfactant therapy.
- Mortality in extremely preterm infants remains elevated due to pulmonary hemorrhage and sepsis.

## Abstract

Respiratory Distress Syndrome (RDS) remains a major cause of morbidity and mortality in preterm neonates, particularly in resource-
limited Level 2 Special Newborn Care Units. Therefore, it is of interest to analyse outcomes of 308 preterm neonates treated with early
Continuous Positive Airway Pressure (CPAP) or combined CPAP-surfactant therapy across three gestational age groups. Survival was highest
with CPAP alone in moderate and late preterm neonates (31-36 weeks), reaching 84.4%-87.3%. Extremely preterm neonates (27-30 weeks) showed
improved outcomes with early selective surfactant plus CPAP, though mortality remained higher due to pulmonary hemorrhage and sepsis. Early
CPAP is highly effective for 31-36-week neonates, while extremely preterm infants benefit most from combined CPAP-surfactant therapy.