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Lung-protective ventilatory strategies in intubated preterm neonates with RDS

F Reiterer1, B Schwaberger1, T Freidl1

  • 1Division of Neonatology, Department of Pediatrics and Adolescence Medicine, Medical University Graz, Austria.

Paediatric Respiratory Reviews
|November 24, 2016
PubMed

Insights

Lung-protective ventilatory strategies (LPVS) for preterm infants with respiratory distress syndrome (RDS) involve various techniques. Optimal outcomes likely result from combining tailored strategies to prevent complications.

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Medicine
  • Critical Care

Background:

  • Respiratory distress syndrome (RDS) is a common condition in preterm infants.
  • Mechanical ventilation is often required but can lead to complications.
  • Lung-protective ventilatory strategies (LPVS) aim to minimize ventilator-induced lung injury.

Purpose of the Study:

  • To review lung-protective ventilatory strategies (LPVS) for intubated preterm infants with RDS.
  • To evaluate the short- and long-term respiratory and neurodevelopmental outcomes associated with these strategies.

Main Methods:

  • Narrative review of existing literature on LPVS in preterm infants with RDS.
  • Description of various strategies including patient-triggered ventilation, volume-targeted ventilation, INSURE technique, open lung concept, high-frequency ventilation, and permissive hypercapnia.

Main Results:

  • No single optimal LPVS can be recommended.
  • Individualized combinations of multiple strategies are likely most effective.
  • Potential serious respiratory and cerebral complications include bronchopulmonary dysplasia and cerebral palsy.

Conclusions:

  • Optimal lung protection in preterm infants with RDS requires a personalized approach.
  • Combining various LPVS may reduce the incidence of bronchopulmonary dysplasia and cerebral palsy.
  • Further research is needed to establish definitive guidelines for LPVS.

Keywords:
Lung protective strategiesRDSmechanical ventilationpreterm infantsshort- and long-term outcome

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