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Ventilator Management in Extremely Preterm Infants

Timothy G Elgin1, Jennifer N Berger2, Brady A Thomas1

  • 1Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA.

Neoreviews
|September 30, 2022
PubMed

Insights

Mechanical ventilation is crucial for extremely preterm infants born before 27 weeks gestation. This review examines evidence for different ventilation modes to improve survival in the Neonatal Intensive Care Unit (NICU).

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Medicine
  • Critical Care

Background:

  • Neonatal Intensive Care Unit (NICU) survival rates for extremely preterm infants have improved due to advanced ventilation strategies.
  • Over 75% of infants born at or before 27 weeks' gestation require mechanical ventilation due to immature lungs and respiratory drive.
  • Various ventilation technologies and management strategies exist for this vulnerable population.

Purpose of the Study:

  • To review the evidence supporting different mechanical ventilation modes for extremely preterm infants.
  • To highlight the importance of individualized ventilator management in the NICU.
  • To provide an overview of current ventilation practices for respiratory failure in neonates.

Main Methods:

  • Literature review of existing evidence on ventilation strategies for extremely preterm infants.
  • Analysis of data on the efficacy of different ventilator types and management approaches.
  • Synthesis of information on conventional, high-frequency oscillatory, and high-frequency jet ventilation.

Main Results:

  • Conventional, high-frequency oscillatory, and high-frequency jet ventilation have all been successfully employed globally.
  • Evidence supports the use of multiple ventilation strategies in managing respiratory failure in this cohort.
  • Individualized approaches are key to optimizing outcomes.

Conclusions:

  • Advances in ventilation have significantly improved survival for extremely preterm infants.
  • A range of effective ventilation modes are available for NICU use.
  • Personalized ventilator management is essential for maximizing the chances of survival and positive outcomes.

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