Related Experiment Video
Updated: Dec 9, 2025
Development of a Neonatal Piglet Acute Lung Injury Model Recreating the Early Environment of Preterm Infant Lungs
Published on: October 31, 2025
Respiratory Support of the Preterm Neonate: Lessons About Ventilation-Induced Brain Injury From Large Animal Models
Kyra Y Y Chan1,2, Suzanne L Miller1,2, Georg M Schmölzer3,4
1The Ritchie Centre, Hudson Institute of Medical Research, Clayton, VIC, Australia.
Insights
Mechanical ventilation for preterm infants can cause brain inflammation and white matter injury. Understanding this link is crucial for improving neurodevelopmental outcomes in vulnerable neonates.
Area of Science:
- Neonatal Medicine
- Neuroscience
- Respiratory Physiology
Background:
- Preterm neonates often require mechanical ventilation, increasing risks of cerebral inflammation and white matter injury.
- The immature brain is particularly vulnerable to injury during the critical period after birth.
- Current understanding of ventilation-induced brain injury (VIBI) needs further development.
Purpose of the Study:
- To review the association between mechanical ventilation and brain injury in preterm neonates.
- To highlight the immediate period after birth, including delivery room and NICU ventilation.
- To discuss the utility and challenges of large animal models in studying VIBI.
Main Methods:
- Literature review focusing on mechanical ventilation and neonatal brain injury.
- Analysis of data from large animal models simulating preterm VIBI.
- Discussion of translational implications and challenges in animal models.
Main Results:
- Mechanical ventilation, especially injurious patterns, is linked to clinically relevant brain injury patterns in animal models.
- Large animal models provide valuable insights into VIBI pathophysiology.
- Reconciling lung and brain maturation presents challenges in commonly used animal models.
Conclusions:
- A comprehensive understanding of VIBI is essential for optimizing care in preterm neonates.
- Improved care strategies guided by VIBI research can enhance neurodevelopmental outcomes.
- Further research using relevant animal models is needed to refine ventilation strategies.
Abstract:
Many preterm neonates require mechanical ventilation which increases the risk of cerebral inflammation and white matter injury in the immature brain. In this review, we discuss the links between ventilation and brain injury with a focus on the immediate period after birth, incorporating respiratory support in the delivery room and subsequent mechanical ventilation in the neonatal intensive care unit. This review collates insight from large animal models in which acute injurious ventilation and prolonged periods of ventilation have been used to create clinically relevant brain injury patterns. These models are valuable resources in investigating the pathophysiology of ventilation-induced brain injury and have important translational implications. We discuss the challenges of reconciling lung and brain maturation in commonly used large animal models. A comprehensive understanding of ventilation-induced brain injury is necessary to guide the way we care for preterm neonates, with the goal to improve their neurodevelopmental outcomes.
