Prenatal and Postnatal Steroids and Pulmonary Outcomes
• Antenatal steroids (ANS) are one of the oldest and most effective therapies in perinatal medicine. • The randomized controlled trials (RCTs) are dated and do not necessarily apply for…
PEDIATRICS
A Physiology-Based Approach to the Respiratory Care of Children With Severe Bronchopulmonary Dysplasia
• The incidence of bronchopulmonary dysplasia (BPD) remains high, but the nature of the disease has evolved from the traditional form marked by extensive fibroproliferative changes to one of alveolar…
Ventilator Strategies to Reduce Lung Injury and Duration of Mechanical Ventilation
Conflict of Interest Statement Dr. Keszler has received honoraria for lectures and research grant support from Dräger Medical. Dr. Keszler also chairs the Data Safety Monitoring Board of a clinical…
Perinatal Events and Their Influence on Lung Development and Injury
• Multiple antenatal exposures have effects on the fetal lung—some adverse and other beneficial for postnatal survival. • Antenatal exposures can alter lung development and interact with postnatal exposures. •…
Pulmonary-Cardiovascular Interaction
• The respiratory and cardiac systems are integrally related both anatomically and functionally and as a result there are significant interactions, particularly in the newborn period. • Inappropriately high airway…
Noninvasive Ventilation of Preterm Infants: An Alternative to Mechanical Ventilation
• Continuous positive airway pressure (CPAP) is an effective respiratory support for preterm infants for a range of indications, especially when delivered via binasal prongs at set pressures equal to…
Oxygenation Instability in the Premature Infant
• Premature infants present with frequent episodes of spontaneous intermittent hypoxemia. These episodes are more prevalent in infants who require prolonged mechanical ventilation. • A common mechanism triggering intermittent hypoxemia…
Optimal Oxygenation in Extremely Preterm Infants
• Targeting appropriate oxygenation in newborn infants can improve outcomes. • Evidence from randomized controlled trials and the corresponding meta-analyses indicate that air vs 100% oxygen for resuscitation of term…
Respiratory and Cardiovascular Support in the Delivery Room
• Following delivery, the processes of lung aeration and increases in pulmonary blood flow are closely linked. • Establishing effective ventilation is the key to successful resuscitation. • Although risk…
Newer Strategies for Surfactant Delivery
• As fewer preterm infants are managed with an endotracheal tube in early life, the usual conduit for surfactant delivery is lacking. With this approach has come a dilemma regarding…
