Silverman-Anderson Score (Preterm Respiratory Distress)
Total Silverman Score
0 / 10
Clinical Severity
No Distress
Management Recommendation
Supportive Observation
1. Upper Chest Movement
2. Lower Chest Retractions
3. Xiphoid Retraction
4. Nares Dilatation (Flaring)
5. Expiratory Grunting
Silverman-Anderson Clinical Interpretation (Preterm RDS):
- Score 0: Normal respiratory mechanics; no respiratory distress.
- Score 1–3: Mild respiratory distress; initiate supplemental humidified oxygen or gentle HFNC.
- Score 4–6: Moderate respiratory distress; early Bubble CPAP (5–7 cm H2O) is standard of care to prevent alveolar collapse.
- Score 7–10: Severe respiratory distress / Impending alveolar collapse; urgent Intubation, Mechanical Ventilation, and Surfactant (e.g. Curosurf / Survanta via LISA/MIST or ETT).