University of Oulu

Sweet D, G, Carnielli V, Greisen G, Hallman M, Ozek E, te Pas A, Plavka R, Roehr C, C, Saugstad O, D, Simeoni U, Speer C, P, Vento M, Visser G, H, A, Halliday H, L: European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update. Neonatology 2019;115:432-450. doi: 10.1159/000499361

European consensus guidelines on the management of respiratory distress syndrome : 2019 update

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Author: Sweet, David G.1; Carnielli, Virgilio2; Greisen, Gorm3;
Organizations: 1Regional Neonatal Unit, Royal Maternity Hospital, Belfast, UK
2Department of Neonatology, Polytechnic University of Marche, and Azienda Ospedaliero-Universitaria Ospedali Riuniti Ancona, Ancona, Italy
3Department of Neonatology, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
4Department of Pediatrics and Adolescence, Oulu University Hospital
5PEDEGO Research Unit, Medical Research Center, University of Oulu, Oulu, Finland
6Department of Pediatrics, Marmara University Medical Faculty, Istanbul, Turkey
7Leiden University Medical Centre, Leiden, The Netherlands
8Division of Neonatology, Department of Obstetrics and Gynecology, General Faculty Hospital and 1st Faculty of Medicine, Charles University, Prague, Czech Republic
9Department of Paediatrics, University of Oxford, Medical Sciences Division, Newborn Services, John Radcliffe Hospitals, Oxford, UK
10Department of Pediatric Research, Oslo University Hospital Rikshospitalet, University of Oslo, Oslo, Norway
11Division of Pediatrics, CHUV & University of Lausanne, Lausanne, Switzerland
12Department of Pediatrics, University Children’s Hospital, Würzburg, Germany
13Department of Pediatrics and Neonatal Research Unit, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain
14Department of Obstetrics and Gynecology, University Medical Centre, Utrecht, The Netherlands
15Department of Child Health, Queen’s University Belfast
16Royal Maternity Hospital, Belfast, UK
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.2 MB)
Persistent link:
Language: English
Published: Karger, 2019
Publish Date: 2019-09-30


As management of respiratory distress syndrome (RDS) advances, clinicians must continually revise their current practice. We report the fourth update of “European Guidelines for the Management of RDS” by a European panel of experienced neonatologists and an expert perinatal obstetrician based on available literature up to the end of 2018. Optimising outcome for babies with RDS includes prediction of risk of preterm delivery, need for appropriate maternal transfer to a perinatal centre and timely use of antenatal steroids. Delivery room management has become more evidence-based, and protocols for lung protection including initiation of CPAP and titration of oxygen should be implemented immediately after birth. Surfactant replacement therapy is a crucial part of management of RDS, and newer protocols for its use recommend early administration and avoidance of mechanical ventilation. Methods of maintaining babies on non-invasive respiratory support have been further developed and may cause less distress and reduce chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease, although minimising time spent on mechanical ventilation using caffeine and, if necessary, postnatal steroids are also important considerations. Protocols for optimising general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome.

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Series: Neonatology
ISSN: 1661-7800
ISSN-E: 1661-7819
ISSN-L: 1661-7800
Volume: 115
Issue: 4
Pages: 432 - 450
DOI: 10.1159/000499361
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
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