Can mechanical ventilation strategies reduce chronic lung disease?
Chronic lung disease (CLD) continues to be a significant complication in newborn infants undergoing mechanical ventilation for respiratory failure. Although the aetiology of CLD is multifactorial, specific factors related to mechanical ventilation, including barotrauma, volutrauma and atelectrauma, have been implicated as important aetiologic mechanisms. This article discusses the ways in which these factors might be manipulated by various mechanical ventilatory strategies to reduce ventilator-induced lung injury. These include continuous positive airway pressure, permissive hypercapnia, patient-triggered ventilation, volume-targeted ventilation, proportional assist ventilation, high-frequency ventilation and real-time monitoring.
The Division of Neonatal-Perinatal Medicine, Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan Health System, Ann Arbor, MI, USA. smdonnmd@med.unich.edu
Steven M
SM
Donn
Sunil K
SK
Sinha
D001997:Bronchopulmonary Dysplasia / Q000628:therapy; D002908:Chronic Disease; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000503:physiopathology; D008171:Lung Diseases / Q000209:etiology / Q000517:prevention & control*; D055370:Lung Injury; D012121:Respiration, Artificial / Q000009:adverse effects* / Q000379:methods*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy; D012307:Risk Factors; D015300:Ventilator Weaning; D012122:Ventilators, Mechanical / Q000009:adverse effects