title: Ventilation strategies for preventing oxidative stress-induced injury in preterm infants with respiratory disease: an update.
abstract: Reactive oxygen and nitrogen species are produced by several inflammatory and structural cells of the airways. The lungs of preterm newborns are susceptible to oxidative injury induced by both reactive oxygen and nitrogen species. Increased oxidative stress and imbalance in antioxidant enzymes may play a role in the pathogenesis of inflammatory pulmonary diseases. Preterm infants are frequently exposed to high oxygen concentrations, infections or inflammation; they have reduced antioxidant defense and high free iron levels which enhance toxic radical generation. Multiple ventilation strategies have been studied to reduce injury and improve outcomes in preterm infants. Using lung protective strategies, there is the need to reach a compromise between satisfaction of gas exchange and potential toxicities related to over-distension, derecruitment of lung units and high oxygen concentrations. In this review, the authors summarize scientific evidence concerning oxidative stress as it relates to resuscitation in the delivery room and to the strategies of ventilation.
authors.affiliation: Neonatal Intensive Care Unit, Children Hospital, Spedali Civili of Brescia, Brescia, Italy, PhD course in Intensive Care, University of Messina, Messina, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Aversa
authors.affiliation: Department of Pediatrics, University of Messina, Messina, Italy. Electronic address: lmarseglia@unime.it.
authors.forename: Lucia
authors.initials: L
authors.lastname: Marseglia
authors.affiliation: Department of Pediatrics, University of Messina, Messina, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Manti
authors.affiliation: Department of Pediatrics, University of Messina, Messina, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: D'Angelo
authors.affiliation: Department of Pediatrics, University of Messina, Messina, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Cuppari
authors.affiliation: Department of Neurosciences, Psychiatric and Anesthesiological Sciences, University of Messina, Messina, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: David
authors.affiliation: Neonatal Intensive Care Unit, Children Hospital, Spedali Civili of Brescia, Brescia, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Chirico
authors.affiliation: Department of Pediatrics, University of Messina, Messina, Italy.
authors.forename: Eloisa
authors.initials: E
authors.lastname: Gitto
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D055370:Lung Injury / Q000517:prevention & control*; D018384:Oxidative Stress; D010102:Oxygen Inhalation Therapy / Q000379:methods; D012121:Respiration, Artificial / Q000379:methods*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D012151:Resuscitation / Q000379:methods; D055397:Ventilator-Induced Lung Injury / Q000517:prevention & control
keywords: lung; oxidative stress; oxygen; preterm newborn; ventilation.