Current trials in the treatment of respiratory failure in preterm infants.

The end of the 20th century brought significant improvements in the outcome of extremely low-birth-weight infants related to the increased use of antenatal corticosteroids and the introduction of postnatal surfactant to prevent or treat respiratory distress syndrome. As we complete the first decade of the 21st century, less progress in improving clinical outcome in this population has been accomplished. Newer modes of ventilation and the use of inhaled nitric oxide have made few demonstrable improvements in outcome. Surprisingly, the greatest hope for improvement may come from the refinement of currently available care including less invasive respiratory support and the combining of various known therapies (such as continuous positive airway pressure and surfactant).