Respiratory Distress Syndrome

A 28-week preterm infant born to a mother with incomplete antenatal corticosteroid coverage presents with respiratory distress within 2 hours of birth. Chest X-ray shows a ground-glass appearance with air bronchograms. Regarding the pathophysiology and management of Respiratory Distress Syndrome (RDS), all of the following are true EXCEPT:

A 32-week preterm infant with RDS is managed with mechanical ventilation and exogenous surfactant. The clinical team is counseling the parents on complications and long-term outcomes. All of the following are recognized complications or sequelae of RDS and its treatment EXCEPT:

A 28-week gestation male infant born to a mother with rupture of membranes 6 hours prior presents with grunting, intercostal retractions, and nasal flaring within 2 hours of birth. Chest X-ray shows a ground-glass appearance with air bronchograms. Arterial blood gas shows pH 7.28, PaCO₂ 52 mmHg, PaO₂ 48 mmHg on room air. What is the most appropriate immediate next step in management?

A 34-week gestation female infant delivered via emergency cesarean section for fetal distress is now 4 hours old. She has mild tachypnea (respiratory rate 58/min), minimal intercostal retractions, and oxygen saturation of 92% on room air. Chest X-ray shows mild hyperinflation with some areas of atelectasis. Blood gas is normal. The infant is feeding well and maintaining temperature. What is the most appropriate next step?

A 28-week gestation male infant is delivered via emergency cesarean section for placental abruption. Birth weight 1.2 kg. At 2 hours of life, the infant develops grunting, nasal flaring, and intercostal retractions. Oxygen saturation drops to 88% on room air. Chest X-ray shows a fine reticular granular pattern with air bronchograms and a ground-glass appearance. What is the most likely diagnosis?