What is the goal of therapy for a neonate with acute respiratory distress syndrome (ARDS)?

The goal of therapy for a neonate with acute respiratory distress syndrome (ARDS) is to maintain oxygen saturation greater than 90%. This target is crucial for ensuring adequate oxygenation to support the neonate's metabolic needs and to minimize the risk of hypoxia, which can lead to further complications. In the context of ARDS, where the lungs are compromised and the ability to exchange gases is diminished, maintaining oxygen saturation above 90% indicates that the infant is receiving sufficient oxygen to sustain organ function and overall health.

While maintaining oxygen saturation above 85% may seem adequate, it is not optimal for a neonate facing the challenges of ARDS. Similarly, while oxygen saturation above 95% is desirable, it may not be achievable in all infants with ARDS, especially those with significant lung injury. Setting a realistic and evidence-based target of greater than 90% helps healthcare providers balance the need for adequate oxygenation with the potential risks of overventilation or excessive oxygen use. Continuous positive airway pressure (CPAP) can be a supportive therapy to help achieve this oxygen saturation target by improving lung recruitment and oxygenation but is not the primary goal in itself.