Non-Invasive Respiratory Support. The Egyptian Consensus on the Management of Neonatal Respiratory Distress Syndrome 2017

NEONATAL CARE NETWORK 2017 (NCN) 

Recommendations

1. CPAP should be started from birth in all babies at risk of RDS, such as those <30 weeks’ gestation who do not need intubation for stabilization (A1).

2. Any one of the several systems of delivering CPAP can be used. However, we recommend the use of a short binasal prong interface, or a mask, and a starting pressure of of about 6–8 cm H 2 O should be applied (A2). CPAP pressure can then be individualized depending on clinical condition, oxygenation and perfusion (D2).

3. CPAP with early rescue surfactant should be considered the optimal management for babies with RDS (A1).

4. Synchronized NIPPV, if delivered through a ventilator can reduce extubation failure, but may not confer long-term advantages such as reduction in BPD (B2).

5. HF nasal canula is not recommended as a primary respiratory support in the delivery room, however, HF may be used as an alternative to CPAP for some babies during the weaning phase (B2).

  • Qual­i­ty of evi­dence
   – High qual­i­ty A    – Mod­er­ate qual­i­ty B    – Low qual­i­ty C    – Very low qual­i­ty D MODIFIED FROM: Euro­pean Con­sen­sus Guide­lines on the Man­age­ment of Res­pi­ra­to­ry Dis­tress Syn­drome – 2016 Update Spon­sored by: abb­vie EGYPT Shar­ing pro­fes­sors:
  • Prof Abdel Rah­man El Mashad (Tan­ta univ)
  • Prof Afaf Kor­raa (Azhar univ)
  • Prof El Sayed Kha­laf (Port fouad hosp, min­istry of health)
  • Prof Iman Eskan­der (Cairo univ)
  • Prof Hes­ham Abdel Hady (Man­soura univ)
  • Prof Hes­ham Ghaz­al (Alexan­dria univ)
  • Prof Mag­da Badawy (Cairo univ)
  • Prof Madi­ha Abdal­la (Minia univ)
  • Prof Magdy Kamel (Minia univ)
  • Prof M Abdel Aaal El Bagy (Sohag univ)
  • Prof Morad El Alfy (Al Galaa mil­i­tary cen­ter)
  • Prof Nahed Fah­my (Cairo univ)
  • Prof Nay­era Ismaeil (Ain Shams univ)
  • Prof Raguia Atwa (Ain Shams univ)
  • Prof Safaa Shafeek (Ain Shams univ)
  • Prof Sozan Gad (Suez canal univ)
  • Prof Osama Hus­sein (Port said neona­tol­ogy soci­ety)
  • Prof Osama Kasem (Al Galaa mil­i­tary cen­ter)
  • Prof Yehia Mah­moud Basha (Daman­hour teach­ing hosp)
  • Prof Zahraa Ezz El Deen (Cairo univ)