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Impact of early respiratory care for extremely preterm infants

Louise S Owen1, Brett J Manley1, Kate A Hodgson2

  • 1Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Australia; Newborn Research Centre, The Royal Women's Hospital, Flemington Road, Parkville, Melbourne, VIC 3052, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.

Seminars in Perinatology
|September 3, 2021
PubMed

Insights

Preventing bronchopulmonary dysplasia (BPD) in extremely preterm infants is crucial. This review examines postnatal respiratory interventions, including ventilation strategies and therapies, to improve outcomes for these vulnerable newborns.

Area of Science:

  • Neonatology
  • Pediatric Respiratory Medicine
  • Critical Care

Background:

  • Bronchopulmonary dysplasia (BPD) affects over half of infants born extremely preterm (<28 weeks' gestation).
  • BPD is linked to significant mortality, morbidity, and long-term respiratory and neurodevelopmental issues.
  • Effective respiratory care for extremely preterm infants spans prenatal, delivery room, and inpatient phases.

Purpose of the Study:

  • To review evidence-based postnatal interventions for extremely preterm infants.
  • To identify strategies that may improve outcomes and prevent BPD.
  • To consolidate current knowledge on respiratory support for this population.

Main Methods:

  • Review of existing literature on postnatal respiratory interventions.
  • Analysis of evidence for various therapeutic approaches.
  • Synthesis of data on timing of interventions and their impact.

Main Results:

  • Evidence supports various strategies to minimize BPD, including judicious use of mechanical ventilation.
  • Non-invasive support, specific ventilation modes, and oxygen saturation targets show promise.
  • Postnatal corticosteroids and adjunct therapies are evaluated for efficacy.

Conclusions:

  • Optimizing respiratory care after birth is essential for extremely preterm infants.
  • A multimodal approach, including tailored ventilation and timely therapies, can reduce BPD incidence and severity.
  • Further research is needed to refine best practices in neonatal respiratory support.

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