title: Unraveling the Links Between the Initiation of Ventilation and Brain Injury in Preterm Infants.
abstract: The initiation of ventilation in the delivery room is one of the most important but least controlled interventions a preterm infant will face. Tidal volumes (V T) used in the neonatal intensive care unit are carefully measured and adjusted. However, the V Ts that an infant receives during resuscitation are usually unmonitored and highly variable. Inappropriate V Ts delivered to preterm infants during respiratory support substantially increase the risk of injury and inflammation to the lungs and brain. These may cause cerebral blood flow instability and initiate a cerebral inflammatory cascade. The two pathways increase the risk of brain injury and potential life-long adverse neurodevelopmental outcomes. The employment of new technologies, including respiratory function monitors, can improve and guide the optimal delivery of V Ts and reduce confounders, such as leak. Better respiratory support in the delivery room has the potential to improve both respiratory and neurological outcomes in this vulnerable population.
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research , Melbourne, VIC , Australia.
authors.forename: Samantha K
authors.initials: SK
authors.lastname: Barton
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research , Melbourne, VIC , Australia ; Department of Obstetrics and Gynecology, Monash University , Melbourne, VIC , Australia.
authors.forename: Mary
authors.initials: M
authors.lastname: Tolcos
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research , Melbourne, VIC , Australia ; Department of Obstetrics and Gynecology, Monash University , Melbourne, VIC , Australia.
authors.forename: Suzie L
authors.initials: SL
authors.lastname: Miller
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research , Melbourne, VIC , Australia ; Newborn Services, John Radcliffe Hospital, Oxford University Hospitals , Oxford , UK.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Roehr
authors.affiliation: Department of Pediatrics, University of Alberta , Edmonton, AB , Canada ; Centre for the Study of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Alberta Health Services , Edmonton, AB , Canada.
authors.forename: Georg M
authors.initials: GM
authors.lastname: Schmölzer
authors.affiliation: Neonatal Services, Newborn Research Centre, The Royal Women's Hospital , Melbourne, VIC , Australia.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Davis
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research , Melbourne, VIC , Australia ; Department of Obstetrics and Gynecology, Monash University , Melbourne, VIC , Australia.
authors.forename: Timothy J M
authors.initials: TJ
authors.lastname: Moss
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research , Melbourne, VIC , Australia.
authors.forename: Domenic A
authors.initials: DA
authors.lastname: LaRosa
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research , Melbourne, VIC , Australia ; Department of Obstetrics and Gynecology, Monash University , Melbourne, VIC , Australia.
authors.forename: Stuart B
authors.initials: SB
authors.lastname: Hooper
authors.affiliation: The Ritchie Centre, Hudson Institute of Medical Research , Melbourne, VIC , Australia ; Department of Obstetrics and Gynecology, Monash University , Melbourne, VIC , Australia.
authors.forename: Graeme R
authors.initials: GR
authors.lastname: Polglase
keywords: brain injury; cerebral palsy; lungs; premature; respiratory support; resuscitation; tidal volume