Ventilatory Strategies in the Prevention and Management of Bronchopulmonary Dysplasia

  • Ambalavanan N
  • Carlo W
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Bronchopulmonary dysplasia (BPD) leads to considerable mortality and morbidity in premature infants. Although mechanical ventilation is lifesaving in infants with respiratory distress syndrome (RDS), it may contribute to lung injury and subsequently to BPD. Appropriate ventilatory strategies for reducing BPD include redefining the goals for "adequate gas exchange," using less mechanical ventilation support, refining the methods of mechanical ventilation, and using alternative techniques. Permissive hypercapnia, permissive hypoxemia, minimal peak pressures, rapid rates, early therapeutic continuous positive airway pressure (CPAP), and rapid extubation may help reduce mechanical ventilation-induced lung injury and possibly reduce BPD. Newer techniques of ventilation such as volume-targeted ventilation are also promising. High frequency ventilation has not been proven to reduce BPD. There is a lack of evidence-based guidelines on management of infants with established BPD. Optimization of clinical care practices and ancillary therapies need to be combined with ventilatory strategies to prevent and manage BPD. © 2006 Elsevier Inc. All rights reserved.

Author-supplied keywords

  • aeration
  • antiinfective agent/dt [Drug Therapy]
  • antiinflammatory agent/dt [Drug Therapy]
  • antioxidant/dt [Drug Therapy]
  • artificial ventilation
  • azithromycin/dt [Drug Therapy]
  • bronchodilating agent/dt [Drug Therapy]
  • bronchopulmonary dysplasia
  • caffeine/ct [Clinical Trial]
  • caffeine/dt [Drug Therapy]
  • clinical practice
  • clinical trial
  • corticosteroid/dt [Drug Therapy]
  • corticosteroid/ih [Inhalational Drug Administratio
  • diuretic agent/dt [Drug Therapy]
  • evidence based medicine
  • extubation
  • gas exchange
  • high frequency ventilation
  • hospital management
  • human
  • hypercapnia
  • hypoxemia
  • lung dysplasia/cn [Congenital Disorder]
  • lung dysplasia/dt [Drug Therapy]
  • lung dysplasia/pc [Prevention]
  • lung dysplasia/th [Therapy]
  • lung injury
  • lung minute volume
  • lung ventilation
  • mechanical ventilation
  • mechanical ventilation weaning
  • morbidity
  • mortality
  • nitric oxide/ct [Clinical Trial]
  • nitric oxide/dt [Drug Therapy]
  • nitric oxide/ih [Inhalational Drug Administration]
  • positive end expiratory pressure
  • practice guideline
  • premature infant
  • prematurity
  • priority journal
  • prophylaxis
  • respiratory airflow
  • respiratory distress syndrome
  • respiratory distress syndrome/cn [Congenital Disor
  • respiratory distress syndrome/dt [Drug Therapy]
  • respiratory distress syndrome/pc [Prevention]
  • respiratory distress syndrome/th [Therapy]
  • retinol/dt [Drug Therapy]
  • review
  • superoxide dismutase/dt [Drug Therapy]
  • surfactant/ct [Clinical Trial]
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  • tidal volume
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  • N Ambalavanan

  • W A Carlo

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