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• Transient airway obstruction (hypoxemia and hypotension)

• Risks of pulmonary barotrauma and haemorrhage from rapidly increased compliance

• Changes in cerebral perfusion from rapid redistribution of pulmonary blood flow into cerebral circulation

Adverse effects of surfactant

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Transient airway obstruction (provoking transient hypoxemia and hypotension) has been demonstrated in premature babies and in newborns due to small airways and reduced diameter of endotracheal tube.