TREATMENT OF NEONATAL RESPIRATORY DISTRESS SYNDROME: SURFACTANT VS. CPAP
DOI:
https://doi.org/10.71248/ks3sfp91Keywords:
Newborn, Respiratory Distress Syndrome Newborn, TherapeuticsAbstract
Neonatal Respiratory Distress Syndrome (NRDS) is one of the leading causes of morbidity and mortality among preterm infants, particularly those born before 32 weeks of gestation. Despite therapeutic advances involving antenatal corticosteroids, exogenous surfactant, and respiratory support, controversies remain the optimal treatment strategy. This study aimed to comparatively analyze the efficacy and safety of surfactant therapy and CPAP in the treatment of NRDS. A systematic review was conducted according to the PRISMA guidelines, with searches performed in the PubMed and Scopus databases between 2015 and 2025. Studies published in English and Portuguese, including clinical trials, randomized controlled trials, and meta-analyses, were included. Of the 1,313 articles identified, nine met the inclusion criteria. The studies compared CPAP alone with CPAP combined with surfactant, as well as different surfactant administration techniques, including INSURE, LISA, MIST, and nebulization. Overall, the combination of surfactant and CPAP resulted in better clinical responses and fewer complications. Less invasive techniques, such as LISA and MIST, demonstrated reductions in oxygen therapy duration, the need for mechanical ventilation, and the risk of bronchopulmonary dysplasia. The evidence suggests that less invasive strategies associated with CPAP provide better clinical outcomes and contribute to the optimization of neonatal care.
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