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Prophylactic Surfactant Administration vs. Alternative Therapies for RDS Prevention in Preterm Infants Born Before 32 Weeks
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Prophylactic Surfactant Administration vs. Alternative Therapies for RDS Prevention in Preterm Infants Born Before 32 Weeks

Paige Anderson, Cherel Fields, Krystin Gandy, Alexa Grundin and Alina Lim
University of West Florida Libraries
Integration of Evidence in Professional Nursing Practice Research Presentations, Research presentations (University of West Florida, Pensacola, Florida, 08/2025)
08/2025

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Abstract

Respiratory distress syndrome (RDS) is the most common complication among preterm infants due to their underdeveloped lungs. These infants not only face RDS but are also at risk for related issues such as apnea, bronchopulmonary dysplasia (BPD), and retinopathy of prematurity (ROP). Current Consensus Guidelines recommend early rescue surfactant therapy within the first two hours after birth, but only if respiratory distress is evident (Cucerea et al., 2023). Investigating whether prophylactic administration offers better outcomes is vital, as it may prevent the onset of RDS altogether and improve recovery in this vulnerable population. Infants born before 32 weeks gestation are at significant risk due to incomplete development of vital organs, including the lungs. At this stage, insufficient surfactant production impairs lung function by allowing alveoli to collapse, making breathing difficult and increasing the risk of RDS. Surfactant serves to reduce surface tension and maintain alveolar stability during exhalation. Without adequate levels, gas exchange is compromised, leading to respiratory failure. This topic is especially important to nursing practice, as it impacts survival rates, reduces the need for invasive interventions such as intubation or mechanical ventilation, and supports earlier discharge from the NICU. A review by the European Society for Pediatric and Neonatal Intensive Care (ESPNIC) found that among eight clinical trials, surfactant replacement in neonates with ARDS improved oxygenation in seven and reduced mortality in one (De Luca et al., 2021). Understanding whether surfactant therapy is more beneficial when given prophylactically versus as a rescue treatment directly informs clinical decision making. Ultimately, this knowledge enhances neonatal outcomes and supports nurses in delivering evidence based, family centered care that facilitates bonding and developmental progress in premature infants.
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