الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Premature infants are at high risk of developing respiratory distress (RD) in the immediate post-natal period. Classically, these preterm babies are managed by endotracheal intubation and mechanical ventilation. The risks of invasive mechanical ventilation to the premature lungs are well known. Even a brief exposure to a large tidal volume can initiate an inflammatory cascade resulting in bronchopulmonary dysplasia (BPD). Avoiding intubation in the delivery room and maintaining infants on nasal continuous positive airway pressure (NCPAP) improves outcomes. NCPAP is now the first-line treatment of premature infants with RD at birth, reducing the need for mechanical ventilation and surfactant therapy. However, NCPAP failure rate remains unacceptably high, with many neonates requiring secondary mechanical ventilation as well as delayed surfactant administration, with increased risk of major morbidity and mortality. Many studies have suggested that NCPAP failure is associated with a greater risk of adverse outcomes, including pneumothorax, intraventricular hemorrhage (IVH) and BPD, than the group in which NCPAP successfully prevents intubation. Identifying infants at risk for NCPAP failure could help target early interventions to avoid intubation and mechanical ventilation