Extract
Ventilatory settings are critical in mechanically ventilated extremely preterm newborn infants due to the risk of ventilation-induced lung injury (VILI) and the subsequent development of bronchopulmonary dysplasia (BPD) [1]. Positive end-expiratory pressure (PEEP) settings usually rely on blood gases, oxygen requirement, lung auscultation, evaluation of chest radiograph and assessment of the pressure/volume curves provided by ventilators. Studies of optimal PEEP settings in the surfactant-treated preterm infant in need of mechanical ventilation are limited and evidence-based clinical guidelines are sparse [2, 3]. A bedside method identifying the PEEP value that comprises maximal lung volume recruitment and minimising tissue overdistension could improve real-time optimisation of PEEP and potentially minimise the risk of VILI and BPD [4, 5].
Abstract
PEEP during ventilation of extremely preterm infants, evaluated by bedside forced oscillation technique in the first week of life, is lower than clinically set PEEP, suggesting that surfactant treated lungs can be easily overdistended even at low PEEP http://bit.ly/2FW1ZAQ
Footnotes
Conflict of interest: L. Wallström has nothing to disclose.
Conflict of interest: C. Veneroni reports that the Politecnico di Milano received research grants from Chiesi Farmaceutici SpA, Acutronic Medical Systems AG and Philips; and Politecnico di Milano owns a patent on the uses of the forced oscillation technique for monitoring lung volume recruitment; Politecnico di Milano also licensed patents on diagnostic application of the forced oscillation technique during mechanical ventilation to Acutronic Medical Systems AG and Philips.
Conflict of interest: E. Zannin reports that the Politecnico di Milano received research grants from Chiesi Farmaceutici SpA, Acutronic Medical Systems AG and Philips; and Politecnico di Milano owns a patent on the uses of the forced oscillation technique for monitoring lung volume recruitment; Politecnico di Milano also licensed patents on diagnostic application of the forced oscillation technique during mechanical ventilation to Acutronic Medical Systems AG and Philips.
Conflict of interest: R.L. Dellacà reports grants from Acutronic, outside the submitted work; in addition, R.L. Dellacà has a patent on the detection of EFL by FOT with royalties paid to Philips Respironics and Restech srl, a patent on monitoring lung volume recruitment by FOT with royalties paid to Vyaire, and a patent on early detection of exacerbations by home monitoring of FOT with royalties paid to Restech.
Conflict of interest: R. Sindelar has nothing to disclose.
- Received August 21, 2019.
- Accepted January 10, 2020.
- Copyright ©ERS 2020