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Ventilator-induced lung injury in preterm infants
Clarissa Gutierrez Carvalho1, Rita C Silveira1, Renato Soibelmann Procianoy1
1Hospital de Clínicas de Porto Alegre, Unidade de Terapia Intensiva Neonatal, Porto AlegreRS, Brasil, Unidade de Terapia Intensiva Neonatal, Hospital de Clínicas de Porto Alegre - HCPA - Porto Alegre (RS), Brasil.
Revista Brasileira De Terapia Intensiva
|February 21, 2014
Summary
Mechanical ventilation can harm preterm infants
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Critical Care
Background:
- Mechanical ventilation is crucial for preterm infants but can cause lung injury.
- Ventilator-induced lung injury (VILI) is linked to bronchopulmonary dysplasia.
- Cytokine-mediated inflammation plays a key role in VILI.
Purpose of the Study:
- To enhance understanding of VILI mechanisms in preterm infants.
- To explore the role of cytokine-mediated inflammation in VILI.
- To inform the development of new preventive strategies against VILI.
Main Methods:
- A comprehensive literature review was conducted.
- Articles were sourced from the PubMed database.
- Search terms included VILI, mechanical ventilation, and bronchopulmonary dysplasia in preterm infants.
Main Results:
- Mechanical ventilation, even briefly, triggers pro-inflammatory cytokine release.
- Interleukins 6 and 8, and tumor necrosis factor alpha are key inflammatory mediators.
- Animal and human newborn studies confirm these findings.
Conclusions:
- Non-invasive ventilation strategies protect against VILI.
- Early surfactant administration and nasal continuous positive airway pressure (CPAP) are beneficial.
- Volume-controlled ventilation strategies mitigate VILI in preterm infants.
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