Table 3.

Summary of current evidence for respiratory management of preterm infants.

Phase	Respiratory Management
Delivery room stabilization	Early initiation of CPAP Noninvasive respiratory support in spontaneously breathing infants to avoid intubation
	Use of T-piece resuscitators Use of oxygen blender Preductal SpO2 > 80% by 5 min of life Target SpO2: 90–95% Avoid prolonged period of hypoxia (SpO2 < 80%) and fluctuation in SpO2
Noninvasive respiratory support in Neonatal Intensive Care Unit	Encourage noninvasive respiratory support (CPAP, NIPPV, SNIPPV) avoiding endotracheal intubation and mechanical ventilation (see Figure 1 and Figure 2) Avoid prolonged period of hypoxia (SpO2 < 80%) and fluctuation in SpO2
Mechanical ventilation in Neonatal Intensive Care Unit	Refer to specific indications for intubation and mechanical ventilation (see Table 1)
	Refer to specific goals of MV Avoid prolonged period of hypoxia (SpO2 < 80%) and fluctuation in SpO2 Choose lung protective ventilation both during CMV and HFOV Consider volume target ventilation strategy both during CMV and HFOV Refer to specific weaning and extubation criteria (i.e., clinical stability, MAP < 8 cm H2O and FiO2 < 30%) Trial of extubation to CPAP/NIPPV/SNIPPV prior to 7 days of life or as early as possible
Surfactant administration	Administer surfactant as early as possible in preterm infants with RDS that require FiO2 > 30% in CPAP ≥ 6 cm H2O