Review Question - QID 109293

A newborn female is evaluated 5 minutes after birth. She was born at 27 weeks of gestation to a 32-year-old primigravid mother via vaginal delivery. The pregnancy was complicated by spontaneous rupture of membranes and preterm labor. The patient’s mother was administered betamethasone and magnesium sulfate upon rupture of membranes and the amniotic fluid was clear. Upon delivery, the patient initially appeared well and had strong respiratory effort. At 1 minute of life, the patient’s APGAR score was 7, and her respiratory effort had diminished to a weak cry. The patient’s birth weight is 976 g (2 lb 2 oz). Her temperature is 98.7°F (37.1°C), blood pressure is 56/39 mmHg, pulse is 137/min, and respirations are 68/min. On physical exam, the patient has nasal flaring and grunting with intercostal retractions. Breath sounds are decreased bilaterally, and she is centrally cyanotic. Her chest radiograph can be seen in Figure A. Which of the following is the most appropriate next step in management?