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Laryngeal Mask Airway LMA Placement in a Neonatal Patient Simulator Using a Non-Inflatable Supraglottic Airway SGA
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Ventilation-Induced Lung Injury (VILI) in Neonates: Evidence-Based Concepts and Lung-Protective Strategies

Renjithkumar Kalikkot Thekkeveedu1, Ahmed El-Saie2,3, Varsha Prakash4

  • 1Section of Neonatology, Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS 39216, USA.

Journal of Clinical Medicine
|February 15, 2022
PubMed

Insights

Mechanical ventilation for neonatal respiratory failure can cause lung injury, a key factor in bronchopulmonary dysplasia. This review explores ventilator-induced lung injury (VILI) pathogenesis and lung-protective strategies for neonates.

Area of Science:

  • Neonatal Medicine
  • Respiratory Physiology
  • Pediatric Critical Care

Background:

  • Mechanical ventilation is crucial for neonatal respiratory failure but can induce or worsen lung injury.
  • Ventilator-induced lung injury (VILI) is a complex condition with multifactorial causes, significantly increasing the risk of bronchopulmonary dysplasia (BPD).
  • Bronchopulmonary dysplasia (BPD) is a common chronic respiratory morbidity in preterm infants, lacking targeted therapies and causing long-term health issues.

Purpose of the Study:

  • To review preclinical and clinical evidence on the pathogenesis and pathophysiology of VILI in neonates.
  • To highlight evidence-based lung-protective strategies for preventing and mitigating VILI and BPD.
  • To provide insights into future research directions for minimizing neonatal VILI.

Main Methods:

  • Review of preclinical and clinical studies on VILI in neonates.
  • Analysis of the multifactorial pathogenesis of VILI, considering ventilator- and patient-related factors.
  • Examination of existing and emerging lung-protective ventilation strategies.

Main Results:

  • VILI is a significant risk factor for BPD, a chronic respiratory condition in preterm infants.
  • Understanding VILI pathogenesis is essential for developing effective mitigation strategies.
  • Lung-protective strategies aim to reduce VILI and its long-term consequences, including BPD.

Conclusions:

  • Effective management of neonatal respiratory failure requires careful consideration of VILI risks.
  • Implementing lung-protective ventilation strategies is critical for attenuating VILI and preventing BPD.
  • Continued research into VILI pathogenesis and novel therapeutic approaches is necessary to improve outcomes for neonates.

Keywords:
atelectraumabiotraumabronchopulmonary dysplasiahyperoxiavolume-targeted ventilationvolutrauma

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