Which treatment is a cornerstone in the management of RDS to maintain adequate oxygenation?

• A. Oxygen therapy to maintain PaO2 > 50 mmHg
• B. Avoid oxygen therapy entirely
• C. Antibiotics only without ventilation
• D. Bed rest with no respiratory support

Answer: (A)

Maintaining adequate oxygenation in RDS relies on correcting hypoxemia with supplemental oxygen and appropriate respiratory support. In RDS, surfactant deficiency causes alveolar collapse and impaired gas exchange, so increasing the inspired oxygen concentration helps raise arterial oxygen content and improve tissue oxygen delivery. A PaO2 above 50 mmHg provides a safety margin to keep oxygen levels adequate without exposing the infant to unnecessary high oxygen concentrations; in practice, this is guided by continuous monitoring and adjusted with FiO2, and by using airway support such as CPAP or mechanical ventilation as needed. Other approaches—avoiding oxygen, using antibiotics alone, or resting without respiratory support—do not address the underlying gas exchange problem and would allow worsening hypoxemia.