• Borko Veković Institute for Neonatology, Belgrade, Serbia
  • Gordana Sekulović Institute for Neonatology, Belgrade, Serbia
  • Zorica Živković Medical Center "Dr Dragiša Mišović-Dedinje" Children’s Hospital for Pulmonary Diseases and Tuberculosis, Belgrade, Serbia, Faculty of Pharmacy Novi Sad, Business Academy in Novi Sad, Novi Sad, Serbia
  • Vesna Veković Medical Center "Dr Dragiša Mišović-Dedinje" Children’s Hospital for Pulmonary Diseases and Tuberculosis, Belgrade, Serbia


extremely premature neonates, respiratory support, surfactant


Bronchopulmonary dysplasia (BPD) is a chronic lung disease of preterm infants, less than 37 weeks of gestational age, and is the most common complication in extremely preterm babies, less than 28 weeks of gestational age. Prematurity itself has a great negative effect on further lung development and has a high risk for future chronic respiratory diseases development and also face a high risk of neonatal mortality. Bronchopulmonary dysplasia occurs when the alveolarization process, the final stage of lung development, is disrupted by preterm birth. All extreme preterm infants needed some kind of respiratory support of invasive and non-invasive mechanical ventilation. Surfactant is used by several techniques. These techniques include: delivery using a thin catheter with the first breath; the intubation-surfactant-extubating procedure (INSURE); less invasive surfactant administration (LISA) technique; using a laryngeal mask airway (LMA); or by nebulisation. There is a great progress in neonatal respiratory care and highlight need to be on further research on respiratory modalities to support extremely premature infants in order to prevent chronic respiratory diseases development.


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Review Articles