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Updated: Aug 9, 2026

Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Neonatal respiratory support and lung function abnormalities at follow-up
1Department of Child Health, King's College Hospital, London, U.K.
Insights
Infants with respiratory distress syndrome (RDS) treated with oxygen alone showed normal lung function. This suggests oxygen therapy, unlike mechanical ventilation, does not independently impair premature infant lung development.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Respiratory distress syndrome (RDS) is a common condition in preterm infants.
- Treatment strategies for RDS include increased inspired oxygen and mechanical ventilation.
- The long-term effects of different RDS treatments on infant lung function require further investigation.
Purpose of the Study:
- To determine if RDS treatment with increased inspired oxygen concentration, without mechanical ventilation, leads to impaired lung function or increased respiratory symptoms.
- To compare lung function and respiratory symptoms in infants treated with oxygen alone versus those who received mechanical ventilation or had no RDS.
Main Methods:
- Measured thoracic gas volume (TGV) and airways resistance (RAW) in eight preterm infants (median gestational age 29 weeks) at 6 and 12 months.
- Compared these infants to two control groups: eight preterm infants who required mechanical ventilation for RDS and eight infants with no history of RDS, matched for gestational age.
- Recorded the occurrence of recurrent respiratory symptoms in all three groups.
Main Results:
- Infants treated with oxygen alone had lung function similar to infants without RDS.
- Airways resistance was significantly lower in the oxygen-treated group compared to the ventilated group at 6 months, but not at 12 months.
- No significant differences in recurrent respiratory symptoms were observed between the groups, though ventilated infants had more symptoms in the first 6 months.
Conclusions:
- Oxygen therapy alone for RDS in preterm infants does not appear to cause lung function impairment independent of prematurity.
- Mechanical ventilation for RDS may be associated with longer-term differences in airway resistance compared to oxygen therapy alone.
- Prematurity is a significant factor influencing long-term lung function in infants treated for RDS.
Abstract:
We have investigated if respiratory distress syndrome (RDS) treated by an increased inspired oxygen concentration, rather than mechanical ventilation, was associated with impaired lung function at follow-up and/or an increase in respiratory symptoms. Thoracic gas volume (TGV) and airways resistance (RAW) were measured in eight pre-term infants (median gestational age 29 weeks) at 6 and 12 months of age. The infants had suffered from RDS but had not required mechanical ventilation. Their results were compared to 16 other infants, matched for gestational age; eight who had required ventilation in the neonatal period and eight who had had no RDS. In all three groups the occurrence of respiratory symptoms was recorded. The lung function of the infants requiring oxygen in the neonatal period was similar to those who had not suffered from RDS, but their airways resistance was significantly lower at 6 but not 12 months than that of infants ventilated in the neonatal period (P less than 0.05). There was no significant difference in recurrent respiratory symptoms between the three groups although a greater proportion of the infants ventilated in the neonatal period were symptomatic in the first 6 months of life. These results suggest that oxygen therapy alone does not result in an impairment of lung function which is independent of the effect of prematurity.
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