Gentle ventilation: the new evidence from the SUPPORT, COIN, VON, CURPAP, Colombian Network, and Neocosur Network trials.
Many neonates have respiratory disorders requiring oxygen supplementation and respiratory support. Even though advances in respiratory care such as surfactant and new ventilatory techniques have improved outcomes, mortality from respiratory failure and morbidities such as bronchopulmonary dysplasia are still common. In the trials of prophylactic, early, or late surfactant, the control infants received mechanical ventilation. It is possible that the control infants had lung injury secondary to mechanical ventilation. This review will address the recent trials of early continuous positive airway pressure (CPAP) as an alternative to the common practice of surfactant and mechanical ventilation.
University of Alabama at Birmingham, Birmingham, AL 35249–7335,USA. wcarlo@peds.uab.edu
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D001997:Bronchopulmonary Dysplasia / Q000517:prevention & control; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D055370:Lung Injury / Q000628:therapy; D015201:Meta-Analysis as Topic; D047928:Premature Birth; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012121:Respiration, Artificial / Q000379:methods*; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000628:therapy
D011663:Pulmonary Surfactants