Volume guarantee versus high-frequency ventilation: lung inflammation in preterm infants

Lista, Gianluca; Castoldi, Francesca; Bianchi, Silvia; Battaglioli, Marina; Cavigioli, Francesco; Bosoni, Mariangela

doi:10.1136/adc.2006.112102

Cited by 44 publications

(24 citation statements)

References 30 publications

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“…Cytokines planned for measurement included interleukin (IL)6 (early peak), as it is an early marker of inflammation, IL8, as it is the most important chemotactic factor in the lung, and tumour necrosis factor (TNF)α (later peak) as it seems to play a role in maintaining chronic inflammation in BPD, utilising a solid-phase, two-site chemiluminescent immunometric assay with automated analyser (Immulite; Medical Systems, Genova, Italy) 15. Blood samples were collected in stable newborns on day 1 (day of birth, after surfactant administration but prior to randomisation) and day 7.…”

Section: Methodsmentioning

confidence: 99%

Nasal continuous positive airway pressure (CPAP) versus bi-level nasal CPAP in preterm babies with respiratory distress syndrome: a randomised control trial

Lista

Castoldi²,

Fontana³

et al. 2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

105

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Objective To evaluate the clinical course, respiratory outcomes and markers of infl ammation in preterm infants with moderate respiratory distress syndrome (RDS) assigned from birth to nasal continuous positive airway pressure (NCPAP) or bi-level NCPAP. Methods A total of 40 infants with a gestational age (GA) of 28-34 weeks (<35 weeks' GA), affected by moderate RDS, were considered eligible and were randomised to NCPAP (group A; n=20, CPAP level=6 cm H 2 O) or to bi-level NCPAP (group B; n=20, lower CPAP level=4.5 cm H 2 O, higher CPAP level=8 cm H 2 O), provided with variable fl ow devices. Infl ammatory response was the primary outcome; serum cytokines were measured on days 1 and 7 of life. Length of ventilation, oxygen dependency, need for intubation and occurrence of air leaks were considered as secondary outcomes.

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Section: Methodsmentioning

confidence: 99%

Nasal continuous positive airway pressure (CPAP) versus bi-level nasal CPAP in preterm babies with respiratory distress syndrome: a randomised control trial

Lista

Castoldi²,

Fontana³

et al. 2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

105

View full text Add to dashboard Cite

show abstract

“…38,[41][42][43][44] In extreme preterm infants, high systemic inflammatory biomarkers are measured in the earliest hours after birth and for extended periods of time during the neonatal period, particularly in infants exposed to mechanical ventilation and supplemental O 2 . [45][46][47][48][49] Preterm infants also have a limited ability to counteract inflammatory and oxidative stress during the neonatal period. 50 Sustained oxidative stress and inflammation are key factors contributing to the development of BPD as well as other neonatal complications.…”

Section: Figurementioning

confidence: 99%

Omega-3 Long-Chain Polyunsaturated Fatty Acids for Extremely Preterm Infants: A Systematic Review

et al. 2014

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BACKGROUND AND OBJECTIVE: Omega-3 long chain polyunsaturated fatty acid (LCPUFA) exposure can be associated with reduced neonatal morbidities. We systematically review the evidence for the benefits of omega-3 LCPUFAs for reducing neonatal morbidities in extremely preterm infants.METHODS: Data sources were PubMed, Embase, Center for Reviews and Dissemination, and the Cochrane Register of Controlled Trials. Original studies were selected that included infants born at ,29 weeks' gestation, those published until May 2013, and those that evaluated the relationship between omega-3 LCPUFA supplementation and major adverse neonatal outcomes. Data were extracted on study design and outcome. Effect estimates were pooled. RESULTS:Of the 1876 studies identified, 18 randomized controlled trials (RCTs) and 6 observational studies met the defined criteria. No RCT specifically targeted a population of extremely preterm infants. Based on RCTs, omega-3 LCPUFA was not associated with a decreased risk of bronchopulmonary dysplasia in infants overall (pooled risk ratio [RR] 0.97, 95% confidence interval [CI] 0.82-1.13], 12 studies, n = 2809 infants); however, when considering RCTs that include only infants born at #32 weeks' gestation, a trend toward a reduction in the risk of bronchopulmonary dysplasia (pooled RR 0.88, 95% CI 0.74-1.05, 7 studies, n = 1156 infants) and a reduction in the risk of necrotizing enterocolitis (pooled RR 0.50, 95% CI 0.23-1.10, 5 studies, n = 900 infants) was observed with LCPUFA.CONCLUSIONS: Large-scale interventional studies are required to determine the clinical benefits of omega-3 LCPUFA, specifically in extremely preterm infants, during the neonatal period. Dr Marc conceptualized and designed the protocol, screened the titles and abstracts, and retrieved articles for inclusion and quality, performed the analyses, drafted the initial manuscript, and approved the final manuscript as submitted; Ms Zhang critically reviewed the protocol, screened the titles and abstracts and retrieved articles for inclusion and quality, drafted the tables and figures, and reviewed the final manuscript as submitted; Dr Lavoie screened the articles for quality, revised the manuscript, participated in the redaction of the final manuscript, and reviewed the final manuscript as submitted; Dr Rhainds designed and conducted the systematic database search, reviewed the manuscript, and approved the final manuscript as submitted; and Dr Lacaze-Masmonteil reviewed the manuscript and approved the final manuscript as submitted.www.pediatrics.org/cgi

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“…[23][24][25] All are relatively small and addressed primarily physiological (mainly pneumothorax and duration of ventilation) and short-term outcomes. A recent meta-analysis of these trials indicates that there is a statistically significant reduction in pneumothorax and in the duration of ventilation, as well as a very strong trend toward decreased chronic lung disease (CLD) in babies treated with volume-targeted ventilation.…”

Section: Pressure Targeted Vs Volume Targetedmentioning

confidence: 99%

Neonatal ventilators: how do they differ?

Donn

2009

J Perinatol

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Remarkable technological advances over the past two decades have brought dramatic changes to the neonatal intensive care unit. Microprocessor-based mechanical ventilation has replaced time-cycled, pressure-limited, intermittent mandatory ventilation with almost limitless options for the management of respiratory failure in the prematurely born infant. Unfortunately, much of the infusion of technology occurred before the establishment of a convincing evidence base. This review focuses on the basic principles of mechanical ventilation, nomenclature and the characteristics of both conventional and high-frequency devices.

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Volume guarantee versus high-frequency ventilation: lung inflammation in preterm infants

Abstract: VG ventilation is an effective lung-protective strategy to be used in acute RDS, inducing a lower expression of early inflammation markers than HFOV. Whether the use of this initial ventilatory strategy contributes to the prevention of BPD requires further studies.

Cited by 44 publications

References 30 publications

Nasal continuous positive airway pressure (CPAP) versus bi-level nasal CPAP in preterm babies with respiratory distress syndrome: a randomised control trial

Nasal continuous positive airway pressure (CPAP) versus bi-level nasal CPAP in preterm babies with respiratory distress syndrome: a randomised control trial

Omega-3 Long-Chain Polyunsaturated Fatty Acids for Extremely Preterm Infants: A Systematic Review

Neonatal ventilators: how do they differ?

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