Archives of Disease in Childhood - Fetal and Neonatal Edition 2008;93:F7-F13
LEADING ARTICLES
Volume-targeted ventilation in the neonate: time to change?
1 Neonatal Unit, Leicester Royal Infirmary, Leicester, UK
2 Department of Health Sciences, University of Leicester, Leicester, UK
Professor D Field, Department of Health Sciences, University of Leicester, 22–28 Princess Road West, Leicester LE1 6TP, UK; david.field@uhl-tr.nhs.uk
Accepted 18 July 2007
| The first 150 words of the full text of this article appear below. |
Advances in neonatal care have led to significant improvement in the survival of preterm infants, but chronic lung disease (CLD) continues to be a major problem.1 Many factors have been linked to the development of CLD2 and a great deal of research has focused on those that are potentially amenable to intervention. Ventilator-induced lung injury (VILI) has been extensively studied. Initially, barotrauma was seen as being of major importance in the aetiology of VILI; however, increasing evidence has suggested that excessive volume, leading to overexpansion (volutrauma), and inadequate volume, leading to underexpansion/collapse, are more important aetiologically.3–6
Time-cycled, pressure-limited ventilation (TCPL) has been the standard mode of ventilation for premature infants with respiratory distress syndrome (RDS) for many years. This mode became popular because of its simplicity and the benefits of being able to control time and pressure in the era before the availability of exogenous surfactant. But a major shortcoming
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