title: Physiology of non-invasive respiratory support.
abstract: Non-invasive ventilation (NIV) is used in neonates to treat extrathoracic and intrathoracic airway obstruction, parenchymal lung disease and disorders of control of breathing. Avoidance of airway intubation is associated with a reduction in the incidence of chronic lung disease among preterm infants with respiratory distress syndrome. Use of nasal continuous positive airway pressure (nCPAP) may help establish and maintain functional residual capacity (FRC), decrease respiratory work, and improve gas exchange. Other modes of non-invasive ventilation, which include heated humidified high-flow nasal cannula therapy (HHHFNC), nasal intermittent mandatory ventilation (NIMV), non-invasive pressure support ventilation (NI-PSV), and bi-level CPAP (SiPAP™), have also been shown to provide additional benefit in improving breathing patterns, reducing work of breathing, and increasing gas exchange when compared with nCPAP. Newer modes, such as neurally adjusted ventilatory assist (NAVA), hold the promise of improving patient-ventilator synchrony and so might ultimately improve outcomes for preterm infants with respiratory distress.
authors.affiliation: Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. Electronic address: alexiouS1@email.chop.edu.
authors.forename: Stamatia
authors.initials: S
authors.lastname: Alexiou
authors.affiliation: The Perelman School of Medicine at The University of Pennsylvania, Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
authors.forename: Howard B
authors.initials: HB
authors.lastname: Panitch
mesh_terms: D045422:Continuous Positive Airway Pressure / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008168:Lung / Q000503:physiopathology*; D012127:Respiratory Distress Syndrome, Newborn / Q000503:physiopathology / Q000628:therapy*; D012129:Respiratory Function Tests
keywords: Lung mechanics; Nasal continuous positive airway pressure; Prematurity; Respiratory distress syndrome