Despite strong evidence of important benefits of volume-targeted ventilation, many high-risk extremely preterm infants continue to receive traditional pressure-controlled ventilation in the United States and elesewhere. Reluctance to abandon one's comfort zone, lack of suitable equipment and a lack of understanding of the subtleties of volume-targeted ventilation appear to contribute to the relatively slow uptake of volume-targeted ventilation. This review will underscore the benefits of using tidal volume as the primary control variable, to improve clinicians' understanding of the way volume-targeted ventilation interacts with the awake, breathing infant and to provide information about evidence-based tidal volume targets in various circmstances. Focus on underlying lung pathophysiology, individualized ventilator settings and tidal volume targets are essential to successful use of this approach thereby improving important clinical outcomes.
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http://dx.doi.org/10.1016/j.semperi.2024.151886 | DOI Listing |
Eur J Pediatr
January 2025
Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, Denmark Hill, London, UK.
Unlabelled: Infants requiring interhospital transfer for a higher level of care in the neonatal period are at increased risk of adverse outcomes. Optimising respiratory management is an important priority. The aim of this survey was to investigate current respiratory support strategies in neonatal transport and identify opportunities for the optimisation of clinical care and future research.
View Article and Find Full Text PDFBMC Pediatr
December 2024
Pediatrics and Neonatology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Objectives: To compare the effect of lung recruitment using high frequency ventilation versus volume targeted ventilation on duration of intubation as well as its effect on lung inflammation in preterm infants with respiratory distress syndrome.
Methods: The study was conducted on a total of 40 preterm infants, 34 weeks gestational age or less, having RDS that needed intubation and mechanical ventilation within the first 72 h after their birth at the NICU of Mansoura University Children's Hospital during the period from July 2020 to July 2022. Infants included were randomly assigned into two groups, Group A who were subjected to LRM using HFOV (20 cases) and Group B who were subjected to LRM using VTV/AC (20 cases).
Semin Fetal Neonatal Med
December 2024
Department of Women and Children's Health, School of Life Course & Population Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK. Electronic address:
Survival rates for extremely low birth weight (ELBW) infants have improved over the recent years, yet morbidity remains high. This review explores respiratory management strategies for this unique cohort and how it may impact their long-term outcomes. Although there is a preference towards non-invasive respiratory support in less immature infants, ELBW infants often require invasive ventilation.
View Article and Find Full Text PDFPediatr Pulmonol
December 2024
Neonatal Intensive Care Unit, Cambridge University Hospitals NHS Trust, Cambridge, UK.
Objective: To evaluate the performance (i.e., agreement between set and measured parameters) and safety (adverse events, device malfunctions, and ventilator alarms) of the fabian HFOi neonatal ventilator in volume guaranteed (VG) mode during conventional ventilation.
View Article and Find Full Text PDFWorld J Pediatr Surg
August 2024
Department of Anesthesia, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
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