Ventilatory strategies for the extremely premature infant

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Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
07:15

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation

Published on: December 5, 2025

Anne Greenough1, Muralidhar Premkumar, Deena Patel

  • 1Division of Asthma, Allergy and Lung Biology, MRC-Asthma Centre, King's College London, London, UK. greenough@kcl.ac.uk

Paediatric Anaesthesia
|March 28, 2008
PubMed

Insights

Mechanical ventilation strategies for premature infants can reduce bronchopulmonary dysplasia (BPD). Research suggests pressure support, proportional assist, and High-Frequency Oscillatory Ventilation (HFOV) may benefit high-risk infants.

Area of Science:

  • Neonatalogy
  • Pediatric Pulmonology
  • Critical Care Medicine

Background:

  • Bronchopulmonary dysplasia (BPD) is a common, adverse outcome in extremely premature infants.
  • Mechanical ventilation, particularly high levels or prolonged use, contributes to BPD development.
  • Identifying lung-protective ventilatory strategies is crucial for this vulnerable population.

Purpose of the Study:

  • To review and critically examine ventilatory techniques aimed at reducing baro/volutrauma and BPD in extremely premature infants.
  • To assess the relevance of existing research findings specifically for high-risk, extremely premature neonates.

Main Methods:

  • Systematic review of randomized studies on ventilatory strategies for premature infants.
  • Focus on techniques potentially reducing lung injury, such as pressure support, proportional assist, and High-Frequency Oscillatory Ventilation (HFOV).

Main Results:

  • Few randomized trials have exclusively focused on extremely premature infants.
  • Studies suggest potential benefits of pressure support, proportional assist, and volume-targeted ventilation in prematurely born infants.
  • High-Frequency Oscillatory Ventilation (HFOV) may mitigate lung function decline in the first year post-birth.

Conclusions:

  • More high-quality randomized controlled trials are needed, exclusively enrolling extremely premature infants at high risk for BPD.
  • Long-term follow-up assessments must be integrated into future studies to accurately determine the benefits and adverse effects of different ventilatory strategies.

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