Home LiteratureArticle Details
PMID: 17541770 Published · ppublish English Journal Article Research Support, Non-U.S. Gov't Review

What is new in ventilation strategies for the neonate?

European journal of pediatrics ·Vol. 166 ·No. 10 ·2007-10-00 ·Pages 991-6

Greenough A, Sharma A

Abstract

A large number of ventilation strategies are now available for the neonate. This review has focused on new information, that is, studies published since 2000 and the implication of their results for current clinical practice. Meta-analysis of randomised trials has demonstrated that assist control and synchronous intermittent mandatory ventilation (SIMV) shortens the duration of ventilation only if started in the recovery rather than the early stage of respiratory disease. A recent randomised trial demonstrated pressure-regulated volume control ventilation may also have no advantages if started early. Weaning by SIMV with pressure support is better (reducing oxygen dependency) than SIMV alone. Meta-analysis of volume-targeted ventilation demonstrated significant reductions in the duration of ventilation and pneumothorax, but the trials were small and of different designs. Volume guarantee may provide more consistent blood gas control. The level of volume targeting appears to be crucial to the success of this technique. Meta-analysis of randomised trials of prophylactic high-frequency oscillation trials has shown a modest reduction in bronchopulmonary dysplasia. Randomised trials have failed to confirm the advantages of nasal continuous positive airway pressure (NCPAP) seen in various non-randomised studies; however, the randomised trials reported to date have been small. Inhaled nitric oxide (NO) does not improve the outcome of prematurely born infants with severe respiratory failure, but early low-dose prolonged iNO appears to have benefits that merit further testing. More randomised trials with long-term outcomes are required to identify the optimal ventilation strategy(ies) for the neonate.

MeSH Terms
Administration, Inhalation Humans Infant, Newborn Nitric Oxide/administration & dosage Respiration, Artificial/methods Respiratory Insufficiency/therapy
Chemicals
Nitric Oxide
Authors & Affiliations
2 authors, click to expand affiliations / ORCID
Greenough Anne
Division of Asthma, Allergy and Lung Biology, King's College London, London, UK. [email protected]
Sharma Atul
References (48)
48 references, click to expand
  1. High flow nasal cannula versus nasal CPAP for neonatal respiratory disease: a retrospective study.
    J Perinatol. 2007 Feb;27(2):85-91 PMID: 17262040
  2. Randomized, controlled trial comparing synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in preterm infants.
    Pediatrics. 2006 Oct;118(4):1409-17 PMID: 17015530
  3. Advantages and disadvantages of different nasal CPAP systems in newborns.
    Intensive Care Med. 2004 May;30(5):926-30 PMID: 15042289
  4. Randomized crossover comparison of proportional assist ventilation and patient-triggered ventilation in extremely low birth weight infants with evolving chronic lung disease.
    Neonatology. 2007;92(1):1-7 PMID: 17596730
  5. Rescue high frequency oscillation and predictors of adverse neurodevelopmental outcome in preterm infants.
    Early Hum Dev. 2002 Feb;66(2):133-41 PMID: 11872317
  6. Randomized trial of continuous positive airways pressure to prevent reventilation in preterm infants.
    Pediatr Pulmonol. 2005 Mar;39(3):247-50 PMID: 15635606
  7. Prophylactic nasal continuous positive airways pressure for preventing morbidity and mortality in very preterm infants.
    Cochrane Database Syst Rev. 2005 Jul 20;(3):CD001243 PMID: 16034858
  8. Prophylactic nasal continuous positive airways pressure in newborns of 28-31 weeks gestation: multicentre randomised controlled clinical trial.
    Arch Dis Child Fetal Neonatal Ed. 2004 Sep;89(5):F394-8 PMID: 15321956
  9. Inhaled nitric oxide in preterm infants undergoing mechanical ventilation.
    N Engl J Med. 2006 Jul 27;355(4):343-53 PMID: 16870913
  10. Effects of pressure support ventilation plus volume guarantee vs. high-frequency oscillatory ventilation on lung inflammation in preterm infants.
    Pediatr Pulmonol. 2006 Mar;41(3):242-9 PMID: 16397875
  11. Variables associated with the early failure of nasal CPAP in very low birth weight infants.
    J Pediatr. 2005 Sep;147(3):341-7 PMID: 16182673
  12. Volume-targeted versus pressure-limited ventilation in the neonate.
    Cochrane Database Syst Rev. 2005 Jul 20;(3):CD003666 PMID: 16034906
  13. Resuscitation and ventilation strategies for extremely preterm infants: a comparison study between two neonatal centers in Boston and Stockholm.
    Acta Paediatr. 2007 Jan;96(1):10-6; discussion 8-9 PMID: 17187596
  14. Accuracy of the volume and pressure displays of high frequency oscillators.
    Arch Dis Child Fetal Neonatal Ed. 2004 Mar;89(2):F174-6 PMID: 14977906
  15. Inhaled nitric oxide in premature infants with the respiratory distress syndrome.
    N Engl J Med. 2003 Nov 27;349(22):2099-107 PMID: 14645637
  16. Comparing two methods of delivering high-flow gas therapy by nasal cannula following endotracheal extubation: a prospective, randomized, masked, crossover trial.
    J Perinatol. 2006 Aug;26(8):481-5 PMID: 16724119
  17. Mechanical ventilation of very low birth weight infants: is volume or pressure a better target variable?
    J Pediatr. 2006 Sep;149(3):308-13 PMID: 16939738
  18. Nasal continuous positive airway pressure: does bubbling improve gas exchange?
    Arch Dis Child Fetal Neonatal Ed. 2005 Jul;90(4):F343-4 PMID: 16036895
  19. Impact of targeted-volume ventilation on lung inflammatory response in preterm infants with respiratory distress syndrome (RDS).
    Pediatr Pulmonol. 2004 Jun;37(6):510-4 PMID: 15114551
  20. Effect of introduction of synchronized nasal intermittent positive-pressure ventilation in a neonatal intensive care unit on bronchopulmonary dysplasia and growth in preterm infants.
    Am J Perinatol. 2006 May;23(4):233-40 PMID: 16625501
  21. Work of breathing using high-flow nasal cannula in preterm infants.
    J Perinatol. 2006 Aug;26(8):476-80 PMID: 16688202
  22. A prospective observational pilot study of synchronized nasal intermittent positive pressure ventilation (SNIPPV) as a primary mode of ventilation in infants > or = 28 weeks with respiratory distress syndrome (RDS).
    J Perinatol. 2004 Aug;24(8):487-93 PMID: 15141265
  23. High-frequency oscillatory ventilation versus conventional mechanical ventilation for very-low-birth-weight infants.
    N Engl J Med. 2002 Aug 29;347(9):643-52 PMID: 12200551
  24. Risk factors for late onset gram-negative sepsis in low birth weight infants hospitalized in the neonatal intensive care unit.
    Pediatr Infect Dis J. 2006 Feb;25(2):113-7 PMID: 16462286
  25. Elective high frequency oscillatory ventilation versus conventional ventilation for acute pulmonary dysfunction in preterm infants.
    Cochrane Database Syst Rev. 2007 Jul 18;(3):CD000104 PMID: 17636590
  26. High-frequency oscillatory ventilation for the prevention of chronic lung disease of prematurity.
    N Engl J Med. 2002 Aug 29;347(9):633-42 PMID: 12200550
  27. Bubble CPAP: is the noise important? An in vitro study.
    Pediatr Res. 2005 Jun;57(6):826-30 PMID: 15774835
  28. Inhaled nitric oxide for respiratory failure in preterm infants.
    Cochrane Database Syst Rev. 2006 Jan 25;(1):CD000509 PMID: 16437426
  29. Lung inflammation in preterm infants with respiratory distress syndrome: effects of ventilation with different tidal volumes.
    Pediatr Pulmonol. 2006 Apr;41(4):357-63 PMID: 16477653
  30. Nitric oxide for respiratory failure in infants born at or near term.
    Cochrane Database Syst Rev. 2000;(2):CD000399 PMID: 10796358
  31. Early inhaled nitric oxide therapy in premature newborns with respiratory failure.
    N Engl J Med. 2006 Jul 27;355(4):354-64 PMID: 16870914
  32. Pulmonary function at follow-up of very preterm infants from the United Kingdom oscillation study.
    Am J Respir Crit Care Med. 2004 Apr 1;169(7):868-72 PMID: 14693671
  33. Long-term outcome of preterm infants treated with nasal continuous positive airway pressure.
    Eur J Pediatr. 2007 May;166(5):473-83 PMID: 17043844
  34. Pressure-regulated volume control ventilation vs synchronized intermittent mandatory ventilation for very low-birth-weight infants: a randomized controlled trial.
    Arch Pediatr Adolesc Med. 2005 Sep;159(9):868-75 PMID: 16143747
  35. Neonatal Ventilation With Inhaled Nitric Oxide Versus Ventilatory Support Without Inhaled Nitric Oxide for Preterm Infants With Severe Respiratory Failure: the INNOVO multicentre randomised controlled trial (ISRCTN 17821339).
    Pediatrics. 2005 Apr;115(4):926-36 PMID: 15805366
  36. Early nasal continuous positive airway pressure in a cohort of the smallest infants in Denmark: neurodevelopmental outcome at five years of age.
    Acta Paediatr. 2004 Feb;93(2):190-5 PMID: 15046272
  37. Adaptive mechanical backup ventilation for preterm infants on respiratory assist modes - a pilot study.
    Intensive Care Med. 2006 Feb;32(2):302-308 PMID: 16432672
  38. Incidence of nasal trauma associated with nasal prong versus nasal mask during continuous positive airway pressure treatment in very low birthweight infants: a randomised control study.
    Arch Dis Child Fetal Neonatal Ed. 2005 Nov;90(6):F480-3 PMID: 15941825
  39. Randomised trial of high frequency oscillatory ventilation or conventional ventilation in babies of gestational age 28 weeks or less: respiratory and neurological outcomes at 2 years.
    Arch Dis Child Fetal Neonatal Ed. 2006 Sep;91(5):F320-6 PMID: 16690640
  40. Volume-controlled intermittent mandatory ventilation in preterm infants with hypoxemic episodes.
    Intensive Care Med. 2006 Apr;32(4):577-84 PMID: 16501947
  41. Sustainable use of continuous positive airway pressure in extremely preterm infants during the first week after delivery.
    Arch Dis Child Fetal Neonatal Ed. 2006 Nov;91(6):F398-402 PMID: 16820391
  42. Prospective randomized multicenter comparison of high-frequency oscillatory ventilation and conventional ventilation in preterm infants of less than 30 weeks with respiratory distress syndrome.
    Pediatrics. 2001 Feb;107(2):363-72 PMID: 11158471
  43. Performance of neonatal ventilators in volume targeted ventilation mode.
    Acta Paediatr. 2007 Feb;96(2):176-80 PMID: 17429900
  44. Is there an advantage of using pressure support ventilation with volume guarantee in the initial management of premature infants with respiratory distress syndrome? A pilot study.
    J Perinatol. 2005 Mar;25(3):193-7 PMID: 15674409
  45. Surfactant administration by transient intubation in infants 29 to 35 weeks' gestation with respiratory distress syndrome decreases the likelihood of later mechanical ventilation: a randomized controlled trial.
    J Perinatol. 2005 Nov;25(11):703-8 PMID: 16163369
  46. Nasal continuous positive airways pressure immediately after extubation for preventing morbidity in preterm infants.
    Cochrane Database Syst Rev. 2000;(3):CD000143 PMID: 10908461
  47. Effects of volume-targeted synchronized intermittent mandatory ventilation on spontaneous episodes of hypoxemia in preterm infants.
    Biol Neonate. 2006;89(1):50-5 PMID: 16155386
  48. Impact of volume guarantee ventilation on arterial carbon dioxide tension in newborn infants: a randomised controlled trial.
    Early Hum Dev. 2007 Mar;83(3):183-9 PMID: 16815649
Article Info
Journal
European journal of pediatrics
Abbr.
Eur J Pediatr
ISSN
0340-6199
DOI
10.1007/s00431-007-0513-0
Email
[email protected]
Published
2007-10-00
Epub
2007-00-02
Pages
991-6
Language
English
Region
Germany
NLM ID
7603873
Subset
IM
External Links
PubMed source DOI: 10.1007/s00431-007-0513-0 View journal details
Analysis Services
Analysis Services

Contact

No. 2 Wenbo Road, Zhangqiu District, Jinan, Shandong

Qilu Normal University · Genelibs Bioinformatics Lab

750 Shunhua Rd, Jinan

2F, Bldg F, University Science Park

Tel: 0531-88819269

WeChat Official Account

Follow our WeChat subscription account for real-time updates and the latest in medical and biological research.


Business Email

E-mail: [email protected]

Copyright © 2026.Genelibs Jinan Honghui Biotechnology Co., Ltd. 鲁ICP备20007159号-2