| Abstract | BACKGROUND: Appropriate ventilation together with improvement of clinical care of premature babies can contribute to reducing lung inflammation, known to represent the "primum movens" of bronchopulmonary dysplasia (BPD). High-frequency oscillatory ventilation (HFOV) and volume-guarantee (VG) ventilation are effective in the treatment of neonatal respiratory distress syndrome (RDS). OBJECTIVE: To assess the potential of HFOV and VG to prevent BPD in the acute phase of RDS, by a randomised clinical study evaluating lung inflammation in premature infants. Study design: Forty infants (gestational age 25-32 weeks) with RDS were assigned to assist-control ventilation plus VG (Vt = 5 ml/kg) or HFOV (both with a Dräger Babylog 8000 plus ventilator). Levels of interleukin (IL) 6, IL8 and tumour necrosis factor were determined in tracheal aspirate on days 1, 3 and 7 of life. RESULTS: In the HFOV group IL6 levels were significantly higher on day 3 (0.5 (0.2) vs assisted-control ventilation plus VG group 0.1 (0.2) ng/ml) and oxygen dependency was significantly longer (36 (23) vs assisted-control ventilation plus VG group 19 (11) days). CONCLUSION: 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. |
| Authors | G Lista, F Castoldi, S Bianchi, M Battaglioli, F Cavigioli, M A Bosoni
(Affiliation: NICU, Vittore Buzzi Children's Hospital, ICP, Via Castelvetro 32, 20154, Milan, Italy. g.lista at icp.mi.it)
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| Journal | Archives of disease in childhood. Fetal and neonatal edition
(Arch Dis Child Fetal Neonatal Ed)
Vol. 93
Issue 4
Pg. F252-6
(Jul 2008)
ISSN: 1468-2052 England |
| PMID | 17405870
(Publication Type: Journal Article, Randomized Controlled Trial)
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| Chemical References |
- Inflammation Mediators
- Interleukins
- Tumor Necrosis Factor-alpha
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| Topics |
- Bronchoalveolar Lavage Fluid
(chemistry)
- Bronchopulmonary Dysplasia
(prevention & control)
- Female
- High-Frequency Ventilation
(adverse effects, methods)
- Humans
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases
(diagnosis, therapy)
- Inflammation Mediators
(analysis)
- Interleukins
(analysis)
- Male
- Positive-Pressure Respiration
(methods)
- Respiratory Distress Syndrome, Newborn
(diagnosis, mortality, therapy)
- Tumor Necrosis Factor-alpha
(analysis)
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