Immediate improvement in lung volume after exogenous surfactant: Alveolar recruitment versus increased distention
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Outcomes following less-invasive-surfactant-administration in the delivery-room
2022, Early Human DevelopmentCitation Excerpt :The findings are similar to those from a study in premature infants in whom lung impedance changes were recorded from 10 min before to 60 min after MIST [21] and demonstrated a rapid increase in end expiratory lung volume, a reduction in tidal and minute volume and stability of carbon dioxide levels [21]. In an early study, surfactant administration improved functional residual capacity [22]. We reported that the tidal volume reduced soon after surfactant administration.
Lung Protection During Mechanical Ventilation in the Premature Infant
2021, Clinics in PerinatologyCitation Excerpt :An in vitro study assessing the inflammatory response at different amounts of cyclical strain designed to mimic what occurs during conventional ventilation or HFOV demonstrated lower levels of IL-6 release in the HFOV exposed alveolar cell analogues.38 The United Kingdom Oscillation Study (UKOS) reported no difference in the primary outcome of mortality or BPD at 36 weeks postmenstrual age in extremely preterm infants randomised to conventional ventilation or HFOV within the first hour after birth (RR, 0.98; 95% CI, 0.89–1.08),39 yet those supported by HFOV had superior lung function at 11 to 14 years of follow-up.40 In that trial,39 a high-volume strategy was used, during which the mean airway pressure (MAP) is increased to improve oxygenation.
Respiratory monitoring during less invasive surfactant administration in the delivery suite
2021, Early Human DevelopmentCitation Excerpt :We saw no significant changes in tidal volumes following LISA and as they received the same CPAP level before and after LISA it is unlikely their compliance had improved. Early studies have demonstrated that surfactant administration does not improve dynamic compliance [16], but does improve functional residual capacity (FRC) and hence gas exchange. The improved oxygenation of our infants 2 h post LISA likely reflects an increased FRC.
Surfactant Treatment
2017, Fetal and Neonatal Physiology, 2-Volume SetPathophysiology of Ventilator-Dependent Infants
2017, Fetal and Neonatal Physiology, 2-Volume SetPhysiology of non-invasive respiratory support
2016, Seminars in Fetal and Neonatal MedicineCitation Excerpt :The neonatal diaphragm and intercostal muscles contain fewer type I muscle fibers than are found in older infants, thus increasing the risk of muscle fatigue [38]. In addition, the lower lung compliance exaggerates the discrepancy between that of the lung and chest wall compliances, further reducing FRC and compromising gas exchange [39–44]. These disadvantages make it difficult for neonates to overcome increased respiratory loads, rendering them susceptible to atelectasis and respiratory failure [32].