New Ways to Ventilate Newborns in Acute Respiratory Failure

McGettigan, Marie C.; Adolph, Vincent R.; Ginsberg, Harley G.; Goldsmith, Jay P.

doi:10.1016/s0031-3955(05)70024-9

Cited by 10 publications

(3 citation statements)

References 87 publications

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“…Currently, investigations concerning the properties and roles of NO encompass such diverse areas as cardiovascular disease; diabetes; respiratory disorders including asthma and inflammatory airway disease; graft versus host disease and transplant physiology; cancer; shock; impotence; peripheral and central nervous system function. Already, treatment strategies utilizing knowledge gained about the properties and functions of NO are being implemented (reviewed by McGettigan et al , 1998; Hobbs et al , 1999; Noss et al , 1999).…”

Section: Introductionmentioning

confidence: 99%

Nitric oxide and tissue destruction

2001

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Nitric oxide (NO) is a free radical which has complex roles in both health and disease. It is now recognized that NO is essential for a vast spectrum of intracellular and extracellular events in a wide variety of tissues. NO has also been implicated in the pathogenesis of numerous inflammatory and autoimmune diseases. In this review we consider the roles of NO generally and in particular the implications for periodontal diseases.

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Section: Introductionmentioning

confidence: 99%

Nitric oxide and tissue destruction

2001

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“…Other HFV modes used in pre-ECMO treatment were high-frequency oscillatory ventilation with IPPV [2] and without IPPV [14] and highfrequency jet ventilation in conjunction with IPPV [9]. At present there is no scientific proof that one HFV mode is superior to the other [15].…”

Section: Discussionmentioning

confidence: 99%

Do we need new indications for ECMO in neonates pretreated with high-frequency ventilation and/or inhaled nitric oxide?

et al. 2000

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“…In 1974, Webb and Tierney demonstrated that PPV could induce lung injury manifested by edema hemorrhage and hyaline membrane formation (2). Asynchrony between the ventilator delivered volume and spontaneous breathing is common during conventional intermittent mandatory ventilation and may result in irregular systemic and cerebral flow patterns, suboptimal gas exchange, barotraumas, airleak syndrome, pulmonary hemorrhage, intraventricular hemorrhage, periventricular leukomalacia, and chronic lung disease (1,3). These complications may be avoided by sedatives or muscle relaxants to minimize the infant's spontaneous breathing.…”

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confidence: 99%

Ventilatory management in extremely low birth weight infants

Morris

Choong²

2020

MJM

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The improvement in survival in premature infants associated with the evolution of mechanical ventilation has been accompanied by an increase in ventilator induced lung injury. High frequency ventilation has been shown to reduce the incidence of ventilator induced lung injury and hence chronic lung disease in the very low birth weight infant. The evolution in understanding how to best use high frequency ventilation in this population has prompted us to ask whether similar strategies to optimize lung volumes on conventional mechanical ventilation can minimize chronic lung disease in the neonate. We retrospectively reviewed the medical charts of 51 extremely low birth weight infants born in Kingston, Ontario in two epochs, 1990 to 1991 and 1999 to 2000, for ventilatory strategy and outcome. From our review, it is clear that surfactant therapy rapidly changes lung mechanics by improving pulmonary compliance and that lung damage may result if there are not changes in the ventilatory management to reflect the altered compliance. Early ventilation strategies during the apparently stable "honeymoon period" in a patient with respiratory distress syndrome (RDS) has significant implications on long term morbidity. In the era prior to the use of surfactant, 30% of infants died and 40% developed chronic lung disease (CLD). Immediately following the use of surfactant, mortality was reduced to 18%, however, the incidence of CLD increased to 78%. In the most recent era, following 10 years of experience with surfactant and mechanical ventilation, morbidity was 17% and CLD 21%. This study demonstrates that a particularly crucial time is in the immediate period following surfactant administration. The use of lower peak inspiratory pressure (PIP) and mean airway pressure (MAP) over the first 24 hours and an increase in the use of synchronous intermittent mandatory ventilation (SIMV) was associated with an improved outcome. The challenge remaining is to determine how to best utilize a conventional mode of ventilation to best optimize lung volume and protect the immature lung.

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New Ways to Ventilate Newborns in Acute Respiratory Failure

Cited by 10 publications

References 87 publications

Nitric oxide and tissue destruction

Nitric oxide and tissue destruction

Do we need new indications for ECMO in neonates pretreated with high-frequency ventilation and/or inhaled nitric oxide?

Ventilatory management in extremely low birth weight infants

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