25 years of respiratory support of newborn infants.
Respiratory support of newborn infants has changed in the last 25 years, because of new knowledge of patho-physiology, controlled studies of respiratory therapy and the realisation of perinatal centers. Respiratory support has changed from the "blow in--suck out" approach, inevitably leading to severe atelectasis, high morbidity and mortality to a now very sophisticated therapy with reduced mortality and morbidity also in very-low-birth-weight infants, who were hopeless patients 25 years ago. Major milestones of this development were the introduction of continuous distending pressure to surfactant deficient lungs, the high-frequency positive pressure ventilation with fine tuning of inspiratory and expiratory times, adjusted to individual time constants and the substitution of artificial surfactant. Techniques for the future, like HFO, NO-inhalation, proportional assist ventilation and liquid ventilation are presently investigated.
Kössel
H
H
Department of Pediatrics, Benjamin Franklin University Hospital, Free University of Berlin, Fed. Rep. of Germany.
Versmold
H
H
D049673:History, 20th Century; D006801:Humans; D006819:Hyaline Membrane Disease / Q000266:history* / Q000628:therapy; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D019102:Infant, Very Low Birth Weight; D008168:Lung / Q000503:physiopathology; D012121:Respiration, Artificial / Q000266:history* / Q000379:methods