Evolving Breathing Support Strategies in Infants Born Preterm: An Overview for Primary Care Clinicians

Primary care clinicians who provide medical homes for neonatal intensive care unit (NICU) graduates may benefit from an enhanced understanding of new breathing support strategies available in NICUs. Understanding the severity of a patient's respiratory course in the NICU may help anticipate the patient's tolerance of future viral illnesses. Primary care clinicians may also serve as the leaders of neonatal resuscitation teams in referring hospitals. Understanding new equipment options in the delivery room setting and the rationale for these changes can help resuscitation teams adopt new practices. This review highlights recent changes in how and when endotracheal intubation is performed, how surfactant is administered for respiratory distress syndrome (RDS), how mechanical ventilation is provided in the hospital setting and occasionally in the home setting via tracheostomy, and how and why noninvasive respiratory support is offered to infants born preterm with active RDS, apnea of prematurity, or ongoing lung growth needs.