Treatment and respiratory support modes for neonates with respiratory distress syndrome

Dassios, Theodore; Ambulkar, Hemant; Greenough, Anne

doi:10.1080/21678707.2020.1769598

Cited by 1 publication

(4 citation statements)

References 116 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The authors concluded that HHFNC should be used as first-line option for respiratory support in centres offering CPAP/ NIPPV as a back-up ( 29 ). In a retrospective study of 134 infants, these who failed HHFNC had lower birth weight, higher inspired oxygen concentrations (FiO 2 ) and maximum flow rate requirements at the time of commencing HHFNC and were more likely to be blood culture positive ( 30 ).…”

Section: Non-invasive Respiratory Supportmentioning

confidence: 99%

“…Non-invasive neurally adjusted ventilator assist (NIV-NAVA) uses electrical signals from the diaphragm to trigger breaths and synchronise the ventilatory support with the infant's respiratory efforts ( 19 ). Studies to date have demonstrated its feasibility in preterm infants, but results are limited to short term outcomes ( 30 ). In a RCT comparing rates of treatment failure between the use of CPAP and NIV-NAVA as a primary mode of respiratory support in very low birth weight (VLBW) infants with RDS, there were no significant differences in the rates of MV, BPD and death between the two groups.…”

Section: Non-invasive Respiratory Supportmentioning

confidence: 99%

“…During assist-control ventilation (ACV), inflations are triggered by every spontaneous breath that exceeds the critical trigger threshold. In synchronised intermittent mandatory ventilation (SIMV), only the pre-set number of inflations are triggered regardless of the infant's spontaneous breathing rate ( 30 ). A Cochrane review of studies comparing patient triggered to conventional mechanical ventilation demonstrated that ACV/SIMV was associated with shorter duration of MV, but no significant reduction in the rates of BPD, severe IVH, air leaks or mortality.…”

Section: Invasive Ventilationmentioning

confidence: 99%

Section: Less Invasive Surfactant Administration (Lisa)mentioning

confidence: 99%

See 3 more Smart Citations

Neonatal respiratory support strategies—short and long-term respiratory outcomes

Kaltsogianni¹,

Dassios²,

Greenough³

2023

Front. Pediatr.

Self Cite

View full text Add to dashboard Cite

Mechanical ventilation (MV), although life-saving, is associated with chronic respiratory morbidity in both preterm and term born infants. New ventilation modes have been developed with the aim of minimising lung injury. These include invasive and non-invasive respiratory support strategies, techniques for less invasive surfactant administration (LISA) and closed-loop automated oxygen control (CLAC) systems. Increasingly, newborn infants with signs of respiratory distress are stabilised on continuous positive airway pressure (CPAP) and receive LISA. Early CPAP when compared to mechanical ventilation reduced the incidence of BPD and respiratory morbidity at 18 to 22 months corrected age. Nasal intermittent positive pressure ventilation reduced treatment failure rates compared to CPAP, but not bronchopulmonary dysplasia (BPD). LISA compared with intubation and surfactant delivery reduced BPD, but there is no evidence from randomised trials regarding long-term respiratory and neurodevelopmental outcomes. Synchronisation of positive pressure inflations with the infant's respiratory efforts used with volume targeting should be applied for infants requiring intubation as this strategy reduces BPD. A large RCT with long term follow up data demonstrated that prophylactic high frequency oscillatory ventilation (HFOV) improved respiratory and functional outcomes at school age, but those effects were not maintained after puberty. CLAC systems appear promising, but their effect on long term clinical outcomes has not yet been explored in randomised trials. Further studies are required to determine the role of newer ventilation modes such as neurally adjusted ventilator assist (NAVA). All such respiratory support strategies should be tested in randomised controlled trials powered to assess long-term outcomes.

show abstract

Section: Non-invasive Respiratory Supportmentioning

confidence: 99%

Section: Non-invasive Respiratory Supportmentioning

confidence: 99%

Section: Invasive Ventilationmentioning

confidence: 99%

Section: Less Invasive Surfactant Administration (Lisa)mentioning

confidence: 99%

See 2 more Smart Citations