Respiratory distress syndrome management in resource limited settings—Current evidence and opportunities in 2022

Frontiers in Pediatrics

article

Osayame A. Ekhaguere¹  Ikechukwu R. Okonkwo²  Maneesh Batra³  Anna B. Hedstrom³ 

[1] Department of Pediatrics, Indiana University School of Medicine;Department of Pediatrics, University of Benin Teaching Hospital;Departments of Pediatrics and Global Health, University of Washington

关键词: respiratory distress syndrome (RDS);    low;    and middle-income countries;    treatment;    surfactant;    continuous positive airway pressure (CPAP);    low resource;    prematurity;   

DOI  :  10.3389/fped.2022.961509

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

The complications of prematurity are the leading cause of neonatal mortality worldwide, with the highest burden in the low- and middle-income countries of South Asia and Sub-Saharan Africa. A major driver of this prematurity-related neonatal mortality is respiratory distress syndrome due to immature lungs and surfactant deficiency. The World Health Organization's Every Newborn Action Plan target is for 80% of districts to have resources available to care for small and sick newborns, including premature infants with respiratory distress syndrome. Evidence-based interventions for respiratory distress syndrome management exist for the peripartum, delivery and neonatal intensive care period- however, cost, resources, and infrastructure limit their availability in low- and middle-income countries. Existing research and implementation gaps include the safe use of antenatal corticosteroid in non-tertiary settings, establishing emergency transportation services from low to high level care facilities, optimized delivery room resuscitation, provision of affordable caffeine and surfactant as well as implementing non-traditional methods of surfactant administration. There is also a need to optimize affordable continuous positive airway pressure devices able to blend oxygen, provide humidity and deliver reliable pressure. If the high prematurity-related neonatal mortality experienced in low- and middle-income countries is to be mitigated, a concerted effort by researchers, implementers and policy developers is required to address these key modalities.

【 授权许可】

CC BY