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Respiratory support of infants born at 22-24 weeks of gestational age

Mikael Norman1, Baldvin Jonsson2, Linda Wallström3

  • 1Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Neonatal Medicine, S3:03 Norrbacka, Karolinska University Hospital, SE-171 76, Stockholm, Sweden.

Seminars in Fetal & Neonatal Medicine
|April 11, 2022
PubMed

Insights

Respiratory support for extremely preterm infants (22-24 weeks gestational age) remains challenging. Optimizing ventilation strategies is crucial to prevent lung damage and bronchopulmonary dysplasia in these vulnerable newborns.

Area of Science:

  • Neonatology
  • Pediatric Pulmonology
  • Perinatal Medicine

Background:

  • Extremely preterm infants (22-24 weeks gestational age) face significant challenges with lung immaturity and acute respiratory failure.
  • Mechanical ventilation and prolonged respiratory support are frequently required, highlighting a critical care gap.
  • Established respiratory support strategies for mature infants are often unsuitable for this population due to developmental differences.

Purpose of the Study:

  • To review current knowledge and challenges in respiratory management for extremely preterm infants.
  • To identify optimal respiratory support strategies tailored to the unique physiology of immature lungs.
  • To address the need for improved methods to prevent lung injury and promote lung development in this cohort.

Main Methods:

  • This review synthesizes existing literature on respiratory care for infants born at 22-24 weeks gestational age.
  • It focuses on the complexities of mechanical ventilation and non-invasive respiratory support.
  • The review examines strategies aimed at minimizing lung damage and fostering lung growth.

Main Results:

  • Lung immaturity in extremely preterm infants necessitates specialized respiratory support.
  • Current evidence suggests a knowledge gap in optimal ventilation strategies for this population.
  • Increased survival rates correlate with rising incidence of bronchopulmonary dysplasia and long-term lung function deficits.

Conclusions:

  • There is a critical need for evidence-based strategies for respiratory support in extremely preterm infants.
  • Avoiding lung injury and promoting lung development are paramount to improving outcomes.
  • Further research is warranted to refine respiratory care for this vulnerable group.

Keywords:
Antenatal corticosteroidsBronchopulmonary dysplasiaExtremely preterm infantMechanical ventilationNeonatal resuscitationNon-invasive respiratory supportSurfactant

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