Nasal CPAP and surfactant for treatment of respiratory distress syndrome and prevention of bronchopulmonary dysplasia

Acta Paediatr. 2009 Sep;98(9):1400-8. doi: 10.1111/j.1651-2227.2009.01413.x. Epub 2009 Jul 1.


The Scandinavian approach is an effective combined treatment for respiratory distress syndrome (RDS) and prevention of bronchopulmonary dysplasia (BPD). It is composed of many individual parts. Of significant importance is the early treatment with nasal continuous positive airway pressure (nCPAP) and surfactant treatment. The approach may be supplemented with caffeine citrate and non-invasive positive pressure ventilation for apnoea. The low incidence of BPD seen as a consequence of the treatment strategy is mainly due to a reduced need for mechanical ventilation (MV).

Conclusion: Early-postnatal treatment with nCPAP and surfactant decreases the severity and mortality of RDS and BPD. This is mainly due to a diminished use of MV in the first days of life.

Publication types

  • Review

MeSH terms

  • Apnea / therapy
  • Bronchopulmonary Dysplasia / prevention & control*
  • Caffeine / therapeutic use
  • Central Nervous System Stimulants / therapeutic use
  • Citrates / therapeutic use
  • Combined Modality Therapy
  • Continuous Positive Airway Pressure / instrumentation
  • Continuous Positive Airway Pressure / methods*
  • Humans
  • Infant, Newborn
  • Positive-Pressure Respiration
  • Pulmonary Surfactants / therapeutic use*
  • Respiration, Artificial / adverse effects
  • Respiratory Distress Syndrome, Newborn / therapy*


  • Central Nervous System Stimulants
  • Citrates
  • Pulmonary Surfactants
  • Caffeine
  • caffeine citrate