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CME: Updates in the medical management of neonatal respiratory distress syndrome (NRDS): best practice and emerging therapies

Activity Description / Statement of Need:

In this online, self-learning activity:

Neonatal respiratory distress syndrome (RDS) occurs in an estimated five to seven percent of term births and up to 90% of preterm births. The risk for neonatal RDS decreases with increasing gestational age,  such that at a gestational age of 37 weeks, the risk has fallen to just three times that of a full-term infant. In addition to premature birth, risk factors for neonatal RDS include maternal gestational diabetes, male sex, multiparity, abnormal fetoplacental circulation, fetal distress, Cesarean delivery, and low birth weight. The ability for the clinician to recognize neonatal RDS is a documented practice gap, and failure to do so is associated with mortality and complications that may include respiratory failure in the short-term and chronic lung disease in the long-term.

Target Audience:

The following healthcare professionals: neonatologists; physician assistants, nurse practitioners, nurses, and pharmacists who practice in neonatology; and any other healthcare professionals with an interest in or who clinically encounter patients with neonatal RDS 

Commercial Support Disclosure: This program is supported by an educational grant from Chiesi USA.

This activity is free of charge.

Release Date: April 26, 2023 -- Expiration Date: April 26, 2025

Faculty: Rangasamy Ramanathan, MD


Faculty introduction, disclosures  

Introduction content: cursory refresher and review of neonatal RDS  

  • Epidemiology 
  • Pathophysiology (including targets of therapy): surfactant deficiency or inactivation, pulmonary edema, impaired gas exchange 
  • Risk factors 
  • Patient case(s) 

Neonatal RDS treatment  

  • Goals of care 
  • Present pharmacotherapy, clinical trial findings, and guideline updates 
  • Antenatal care, corticosteroids 
  • Candidates and literature support by gestational age 
  • Fetal and maternal side effects, long-term effects 
  • Rescue therapy 
  • Initial management, surfactant 
  • Indications 
  • Timing 
  • Administration technique 
  • Emerging evidence: therapies and administration techniques 
  • Additional complications and their management, supportive care 
  • Patient case(s) 

Summary, conclusions, and best practice recap 

Learning Objectives

By the end of the session the participant will be able to:

  • Recall the pathophysiology and healthcare burden of neonatal RDS.
  • Discuss present and investigational therapies and administration strategies for the treatment of neonatal RDS.
  • Formulate a plan of care for a neonate with RDS .


ACCME Activity #202470464

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through ScientiaCME. ScientiaCME is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: ScientiaCME designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™ toward the AMA Physician's Recognition Award. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ABP MOC Recognition Statement: Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Pediatrics' (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABP MOC credit.

ABP MOC Credit Type: Lifelong Learning and Self-Assessment

Physicians: For maintenance of certification (MOC) points, you must enter your board certification ID # and birth date correctly.  It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive MOC points for this activity. By providing this data, you acknowledge that it will be shared with ACCME and the applicable certifying board. Please note: Not all activities on this site provide MOC points. If this activity does not specify that it provides MOC points in this section, then it does NOT provide MOC points. This activity provides MOC points only for ABP.


ScientiaCME is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This activity is approved for 1.0 contact hours (0.1 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the post-test. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit. ACPE #0574-0000-23-014-H01-P. This is an Application (A)-type activity. 

PharmacistsYou must enter your NABP # and birth date correctly so that proof of participation can be posted to your NABP CPE profile. It is the learner's responsibility to provide this information completely and accurately at the completion of the activity. Without providing it, the learner will NOT receive CPE credit for this activity.

Nurse Practitioners (NPs): The American Academy of Nurse Practitioners accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME. ScientiaCME will provide NPs who successfully complete each activity with a certificate of participation indicating that the activity was designated for AMA PRA Category 1 Credit(s)™.

Physician Assistants: The American Academy of Physician Assistants accepts AMA PRA Category 1 Credit(s)™ from organizations accredited by the ACCME.

Faculty Disclosure and Resolution of COI

As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved through content review by ScientiaCME.

Disclosure of Faculty: Rangasamy Ramanathan, MD, Professor of Pediatrics, Keck School of Medicine of USC, has received financial compensation for consulting and research from Chiesi USA and Chiesi Framaceutici (Italy).

Disclosures of Educational Planners: Charles Turck, PharmD, BCPS, BCCCP, President of ScientiaCME, has no relevant financial disclosures.

Faculty WILL NOT discuss off-label uses.

All relevant financial relationships have been mitigated.

ScientiaCME adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.

Commercial Support Disclosure: This program is supported by an educational grant from Chiesi USA.


  • Read the learning objectives above
  • Take the Pre-Test (optional). Completion of the pre-test will help us evaluate the knowledge gained by participating in this CME activity.
  • View the online activity. You may view this is in more than one session, and may pause or repeat any portion of the presentation if you need to.
  • Minimum participation threshold: Take the post-test. A score of 70% or higher is required to pass and proceed to the activity evaluation.
  • Complete the activity evaluation and CME registration. A CE certificate will be emailed to you immediately.

Cultural/Linguistic Competence & Health Disparities

System Requirements

Windows 7 or above
Internet Explorer 8
*Adobe Acrobat Reader
Mac OS 10.2.8
Safari or Chrome or Firefox
*Adobe Acrobat Reader
Internet Explorer is not supported on the Macintosh

*Required to view Printable PDF Version

Perform Pre-Test (optional)

Please take a few minutes to participate in the optional pre-test. It will help us measure the knowledge gained by participating in this activity.

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