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Lung protective ventilation in extremely preterm infants


Dargaville, PA and Tingay, DG, Lung protective ventilation in extremely preterm infants, Journal of Paediatrics and Child Health, 48, (9) pp. 740-746. ISSN 1034-4810 (2012) [Refereed Article]

Copyright Statement

Copyright 2012 The Authors

DOI: doi:10.1111/j.1440-1754.2012.02532.x


The lungs of an extremely preterm infant °‹28 weeks gestation are structurally and biochemically immature and vulnerable to injury from positive pressure ventilation. A lung protective approach to respiratory support is vital, aiming to ventilate an open lung, using the lowest pressure settings that maintain recruitment and oxygenation and avoiding hyperinflation with each tidal breath. For infants with severe respiratory distress syndrome and persistent atelectasis, lung protective ventilation requires recruitment using stepwise pressure increments, followed by reduction in ventilator pressures in search of an optimal point at which to maintain ventilation. Several studies, including a single randomised controlled trial, have found this lung protective strategy to be more effectively administered using high-frequency oscillatory ventilation rather than conventional ventilation. Many extremely preterm infants have minimal atelectasis and low oxygen requirements in the first days of life, and the ventilatory approach in this case should be one of avoidance of factors including overdistension that are known to contribute to later pulmonary deterioration. From a practical perspective, this means setting positive end-expiratory pressure at the lowest value that maintains oxygenation and restricting tidal volume using a volume-targeted mode of ventilation.

Item Details

Item Type:Refereed Article
Keywords:high-frequency ventilation, infant, mechanical ventilation, newborn, pressure®Cvolume relationship, ventilator-induced lung injury
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Intensive care
Objective Division:Health
Objective Group:Clinical health
Objective Field:Clinical health not elsewhere classified
UTAS Author:Dargaville, PA (Professor Peter Dargaville)
ID Code:85093
Year Published:2012
Web of Science® Times Cited:37
Deposited By:Research Division
Deposited On:2013-06-13
Last Modified:2017-11-06

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