NEW APPROACHES IN THE MANAGEMENT OF RESPIRATORY DISTRESS SYNDROME IN PRETERM INFANTS: A NARRATIVE REVIEW

Abstract

Respiratory distress syndrome (RDS) remains one of the leading causes of neonatal morbidity and mortality among preterm newborns, particularly due to pulmonary immaturity and surfactant deficiency. Over recent decades, novel therapeutic strategies have contributed to reducing the need for invasive mechanical ventilation, minimizing lung injury, and improving neonatal outcomes. The present study aimed to analyze new approaches related to the management of RDS in preterm infants, with emphasis on noninvasive respiratory support, surfactant therapy, minimally invasive administration techniques, and protective ventilation strategies. This study consists of a Narrative Literature Review conducted through searches in databases including PubMed, Scopus, Web of Science, SciELO, and ScienceDirect, covering publications from 2016 to 2026. The research question was developed according to the PICo strategy, considering preterm newborns with RDS, contemporary therapeutic approaches, and the context of neonatal intensive care. The findings demonstrate that early nasal CPAP, LISA/MIST techniques, and volume-targeted ventilation have assumed a central role in reducing intubation rates, exposure to invasive ventilation, and respiratory complications. Furthermore, controlled oxygenation strategies, continuous monitoring, and emerging therapies such as aerosolized surfactant indicate promising perspectives. Nevertheless, challenges related to protocol standardization, multiprofessional training, technological availability, and equitable access still persist. It is concluded that the contemporary management of RDS in preterm infants is moving toward increasingly individualized, protective, and less invasive approaches.