Ventilator-induced Lung Injury in Preterm Infants

Overview

Journal Rev Bras Ter Intensiva

Specialties Critical Care
General Medicine

Date 2014 Feb 21

PMID 24553514

Citations 25

Authors

Clarissa Gutierrez Carvalho

Rita C Silveira

Renato Soibelmann Procianoy

Affiliations

Soon will be listed here.

Abstract

In preterm infants, the need for intubation and mechanical ventilation is associated with ventilator-induced lung injuries and subsequent bronchopulmonary dysplasia. The aim of the present review was to improve the understanding of the mechanisms of injury that involve cytokine-mediated inflammation to contribute to the development of new preventive strategies. Relevant articles were retrieved from the PubMed database using the search terms "ventilator-induced lung injury preterm", "continuous positive airway pressure", "preterm", and "bronchopulmonary dysplasia". The resulting data and other relevant information were divided into several topics to ensure a thorough, critical view of ventilation-induced lung injury and its consequences in preterm infants. The role of pro-inflammatory cytokines (particularly interleukins 6 and 8 and tumor necrosis factor alpha) as mediators of lung injury was assessed. Evidence from studies conducted with animals and human newborns is described. This evidence shows that brief periods of mechanical ventilation is sufficient to induce the release of pro-inflammatory cytokines. Other forms of mechanical and non-invasive ventilation were also analyzed as protective alternatives to conventional mechanical ventilation. It was concluded that non-invasive ventilation, intubation followed by early surfactant administration and quick extubation for nasal continuous positive airway pressure, and strategies that regulate tidal volume and avoid volutrauma (such as volume guarantee ventilation) protect against ventilator-induced lung injury in preterm infants.

Citing Articles

Predicting extubation failure in neonates: The role of lung ultrasound and corrected gestational age in safe weaning in the NICU.

Rojas B, Procianoy R, de Souza A, Rigodanzo C, Trindade G, Furlan S Eur J Pediatr. 2025; 184(2):144.

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A comprehensive study on machine learning models combining with oversampling for bronchopulmonary dysplasia-associated pulmonary hypertension in very preterm infants.

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The influence of chorioamnionitis on respiratory drive and spontaneous breathing of premature infants at birth: a narrative review.

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Risk of dysphagia in a population of infants born pre-term: characteristic risk factors in a tertiary NICU.

Dewi D, Rachmawati E, Wahyuni L, Hsu W, Tamin S, Yunizaf R J Pediatr (Rio J). 2023; 100(2):169-176.

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Effects of critical illness on the functional status of children with a history of prematurity.

Peduce M, Dannenberg V, Rovedder P, Carvalho P Rev Bras Ter Intensiva. 2023; 34(4):469-476.

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