Preterm infants with respiratory distress syndrome are commonly managed with which noninvasive ventilation strategy?

• A. High-flow nasal cannula
• B. CPAP
• C. BiPAP
• D. Venturi mask

Answer: (B)

In preterm infants with respiratory distress syndrome, the key goal is to keep the tiny, surfactant-deficient lungs open and recruit already collapsed alveoli. Providing a constant positive airway pressure achieves this by maintaining a steady distending pressure throughout the breathing cycle, which helps preserve functional residual capacity, improves gas exchange, reduces the work of breathing, and lowers the need for intubation and mechanical ventilation. This makes continuous positive airway pressure the standard noninvasive strategy for initial management.

High-flow nasal cannula can deliver warmed, humidified gas and may offer some degree of gentle pressure, but the pressure it provides is variable and less reliable for preventing atelectasis in classic RDS. BiPAP adds intermittent higher and lower pressures, which can be useful in certain situations (like after extubation or when more support is needed), but it is not the first-line approach for routine management of surfactant-deficient lungs. Venturi masks simply deliver oxygen without positive pressure, which isn’t sufficient to keep the alveoli open in RDS.

So the best-fit noninvasive strategy is continuous positive airway pressure because it directly supports lung recruitment and stable oxygenation in this setting.