Division of Pediatrics and Neonatal Critical Care, "Antoine Béclère" Hospital, Paris Saclay University Hospitals, APHP, Paris, France; Physiopathology and Therapeutic Innovation Unit-INSERM U999, Paris Saclay University, Paris, France.
Pediatr Neonatol. 2021 Feb;62 Suppl 1:S3-S9. doi: 10.1016/j.pedneo.2020.11.005. Epub 2020 Dec 5.
Respiratory distress syndrome (RDS) was recognized to be caused by primary surfactant deficiency almost 70 years ago and continuous positive airway pressure was introduced approximately 50 years ago. Since then, there have been many developments in neonatology; we know many things but others are still controversial. The more we know, the more questions arise. However, this review aims to indicate what is more needed to understand and how should be the modern approach to RDS in the era of precision medicine. The review is divided between new concepts and new tools. We will explain the interaction between steroids, CPAP and surfactant, as well as the surfactant catabolism and the diagnosis of NARDS; lung ultrasound and new tools to optimize CPAP will also be covered. How these concepts are integrated in the author's personal experience is also illustrated.
呼吸窘迫综合征（RDS）几乎在 70 年前被认为是由原发性表面活性剂缺乏引起的，而持续气道正压通气（CPAP）大约在 50 年前被引入。从那时起，新生儿学领域有了许多发展；我们知道了很多事情，但其他事情仍存在争议。我们知道的越多，提出的问题就越多。然而，本次综述旨在指出在精准医学时代，我们还需要了解什么，以及应该如何采用现代方法来治疗 RDS。该综述分为新概念和新工具两部分。我们将解释类固醇、CPAP 和表面活性剂之间的相互作用，以及表面活性剂的代谢和 NARDS 的诊断；也将涵盖肺超声和优化 CPAP 的新工具。还说明了这些概念如何融入作者的个人经验。
