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- Title
Ventilation, oxidative stress and risk of brain injury in preterm newborn.
- Authors
Cannavò, Laura; Rulli, Immacolata; Falsaperla, Raffaele; Corsello, Giovanni; Gitto, Eloisa
- Abstract
Preterm infants have an increased risk of cognitive and behavioral deficits and cerebral palsy compared to term born babies. Especially before 32 weeks of gestation, infants may require respiratory support, but at the same time, ventilation is known to induce oxidative stress, increasing the risk of brain injury. Ventilation may cause brain damage through two pathways: localized cerebral inflammatory response and hemodynamic instability. During ventilation, the most important causes of pro-inflammatory cytokine release are oxygen toxicity, barotrauma and volutrauma. The purpose of this review was to analyze the mechanism of ventilation-induced lung injury (VILI) and the relationship between brain injury and VILI in order to provide the safest possible respiratory support to a premature baby. As gentle ventilation from the delivery room is needed to reduce VILI, it is recommended to start ventilation with 21–30% oxygen, prefer a non-invasive respiratory approach and, if mechanical ventilation is required, prefer low Positive End-Expiratory Pressure and tidal volume.
- Subjects
ARTIFICIAL respiration; BRAIN injuries; LUNG injuries; RESPIRATORY measurements; RISK assessment; MECHANICAL ventilators; OXIDATIVE stress; HOSPITAL birthing centers; POSITIVE end-expiratory pressure; DISEASE complications; DISEASE risk factors; CHILDREN
- Publication
Italian Journal of Pediatrics, 2020, Vol 46, Issue 1, p1
- ISSN
1720-8424
- Publication type
Article
- DOI
10.1186/s13052-020-00852-1