SURFACTANT THERAPY OF RESPIRATORY DISORDERS IN NEWBORNS: What is new? (Literature review)

The mainstay of treatment for respiratory distress syndrome (RDS) in preterm infants is the maintenance of constant positive airway pressure (CPAP) and the administration of surfactant. Nearly 50 years after the first clinical use of CPAP and 40 years of experience with surfactant administration in preterm infants, the essential questions of defining "who are the preterm infants with respiratory distress who have received CPAP and what is the real benefit of surfactant" remain unanswered. Many years of clinical research and professional discussions suggest the need to introduce surfactant therapy in the era of personalized medicine to improve its effectiveness, as individual patient needs and risk-benefit ratios may vary significantly in individual clinical cases. In an attempt to answer the above question in the context of modern optimal perinatal care, we offer a comprehensive overview of the latest innovations in surfactant therapy and current results of major clinical trials presented at the international scientific conferences - PAS, NPMF and SPIN, which took place in the first half of 2024. The presented preliminary results of ongoing international clinical trials (SurfON, PLUSS) and the proposed training program for neonatologists (Delphi) emphasize the understanding of the neonatal community of the significance, importance and benefits of surfactant therapy in preterm infants, demonstrating the need to expand the medical indications for surfactant administration, particularly to late preterm infants with RDS. The latest information on approaches to the treatment of respiratory disorders in late preterm infants, preliminary results of ongoing international clinical trials, will increase the professional awareness of neonatologists, pediatric anesthesiologists in NICUs and perinatal centers, and help to apply the knowledge gained in practice.