Approach to the Neonate with Respiratory Distress

Approach to the Neonate with Respiratory Distress Maryam saeedi. MD-MPH. neonatologist children medical center, Tehran university of medical science. Background: Neonatal respiratory distress is among the most frequent and critical presentations in neonates, affecting both preterm and term infants. Timely recognition and management are important to reduce morbidity and mortality. Methods/Approach: This abstract has reviewed recent evidence, focusing on stabilization, noninvasive and invasive ventilation and adjunct therapies. Key Findings: Early CPAP (۵-۸ cmH۲O) is first-line; HFNC may be not be appropriable for preterm infants. NIPPV reduces failure compared to CPAP in high-risk groups. Surfactant Therapy: LISA/MIST preferred over INSURE; early caffeine with LISA may reduce intubation rates. Oxygen Management: avoid hyperoxia. Permissive hypercapnia tolerated if pH >۷.۲۵. Lung sonography(LUS): Effective for differentiating RDS, TTN, pneumonia, MAS, and pneumothorax. PPHN: Identified by pre/post-ductal SpO۲ difference and echocardiography; inhaled nitric oxide remains first-line vasodilator. Antibiotic use Avoid unnecessary treatment in TTN/RDS without risk factors. Conclusion: A structured, evidence-based approach, focusing on early CPAP, selective LISA, oxygen targeting, LUS-guided diagnosis, optimizes neonatal respiratory distress outcomes.