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Non-invasive Respiratory Support of the Premature Neonate: From Physics to Bench to Practice

Ibrahim Sammour1, Sreenivas Karnati1

  • 1Department of Neonatology, Lerner College of Medicine, Pediatric Institute, Cleveland Clinic, Cleveland Clinic Foundation, Cleveland, OH, United States.

Frontiers in Pediatrics
|May 28, 2020
PubMed

Insights

Non-invasive respiratory support is increasingly used for premature infants to reduce Bronchopulmonary Dysplasia (BPD) risks. This review covers its basis, evidence, and advancements in neonatal care.

Area of Science:

  • Neonatology
  • Pediatric Respiratory Medicine

Background:

  • Global rise in premature births necessitates advanced respiratory support for neonates.
  • Extremely preterm infants face high risks of respiratory distress syndrome and Bronchopulmonary Dysplasia (BPD).
  • Prolonged invasive mechanical ventilation is linked to increased BPD and comorbidities.

Purpose of the Study:

  • To review the physical and biological basis of non-invasive respiratory support in neonates.
  • To evaluate current clinical evidence for non-invasive respiratory support modalities.
  • To discuss recent technological advancements in neonatal respiratory care.

Main Methods:

  • Literature review of non-invasive respiratory support in preterm infants.
  • Analysis of pathophysiology and clinical evidence for various non-invasive modalities.
  • Synthesis of recent developments and practice variations in neonatal respiratory support.

Main Results:

  • Non-invasive respiratory support is gaining popularity as an alternative to invasive ventilation.
  • Evidence supports non-invasive methods for initial support and post-extubation in preterm infants.
  • Technological advancements are improving the efficacy and application of non-invasive respiratory support.

Conclusions:

  • Non-invasive respiratory support offers a promising approach to mitigate BPD in preterm infants.
  • Standardizing practices and further research are needed to optimize non-invasive respiratory support.
  • This review provides a comprehensive overview for clinicians managing respiratory insufficiency in neonates.

Keywords:
Bronchopulmonary dysplasiaCPAPbubble CPAPhigh flow nasal cannulanasal high frequency ventilationneurally adjusted ventilator assist (NAVA)non-invasive ventilation

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