Non-invasive respiratory support in preterm infants: do we need more evidence?

Although exogenous surfactant replacement and mechanical ventilation remain the standard of care for treatment of respiratory distress syndrome in preterm infants, non-invasive forms of respiratory support are increasingly used in the belief that they are associated with fewer complications and reduce the risk of bronchopulmonary dysplasia. This is not yet fully proven despite indications that non-invasive ventilation may be as effective as mechanical ventilation, at least in the short-term. Moreover, non-invasive respiratory support can be provided in a variety of ways and there is no consensus about the optimal use of these newer techniques.