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Keywords Abstract
Antenatal steroids · Continuous positive airway As management of respiratory distress syndrome (RDS) ad-
pressure · Evidence-based practice · Hyaline membrane vances, clinicians must continually revise their current prac-
disease · Mechanical ventilation · Nutrition · Oxygen tice. We report the fourth update of “European Guidelines
supplementation · Patent ductus arteriosus · Preterm for the Management of RDS” by a European panel of experi-
infant · Respiratory distress syndrome · Surfactant therapy · enced neonatologists and an expert perinatal obstetrician
Thermoregulation based on available literature up to the end of 2018. Optimis-
ing outcome for babies with RDS includes prediction of risk
of preterm delivery, need for appropriate maternal transfer
These updated Guidelines contain new evidence from recent Co- to a perinatal centre and timely use of antenatal steroids.
chrane reviews and the medical literature since 2016. Strength of ev- Delivery room management has become more evidence-
idence supporting recommendations has been evaluated using the based, and protocols for lung protection including initiation
GRADE system. The prenatal care section has been updated by Prof.
Gerard H.A. Visser. There are also new recommendations covering of CPAP and titration of oxygen should be implemented im-
less invasive surfactant administration. This guideline has been en- mediately after birth. Surfactant replacement therapy is a
dorsed by the European Society for Paediatric Research (ESPR). crucial part of management of RDS, and newer protocols for
Appendix
Summary of Recommendations