Positive Pressure, and Pulse Oximetry Randomized Trial)

CPAP is the most studied form of noninvasive ventila-tion in neonates, and early investigations focused on the use of CPAP following surfactant administration, to min-imize the need for invasive mechanical ventilation.1 Ver-der and colleagues demonstrated that a strategy of CPAP following brief intubation and surfactant administration (the INSURE technique: INtubation, SURfactant, Extuba-tion) improved outcomes in patients with respiratory dis-tress syndrome (RDS),2 and those results were replicated in multiple randomized controlled trials.3 In addition, early observational studies also suggested that preterm neonates treated with CPAP alone (without endotracheal intubation and surfactant) had less need for mechanical ventilation.4-