Impact of targeted‐volume ventilation on lung inflammatory response in preterm infants with respiratory distress syndrome (RDS)

Pediatric Pulmonology - Tập 37 Số 6 - Trang 510-514 - 2004
Gianluca Lista1, Maria Rosa Colnaghi2, Francesca Castoldi1, Valentina Condò2, R. Reali3, G Compagnoni1, Fabio Mosca2
1Neonatal Intensive Care Unit "V. Buzzi," Children's Hospital, Azienda ICP, Milan, Italy
2Neonatal Intensive Care Unit "Clinica Mangiagalli," Department of Neonatology, Children's Hospital, Azienda ICP, Milan, Italy
3Laboratory "V. Buzzi," Children's Hospital, Azienda ICP, Milan, Italy

Tóm tắt

AbstractVolutrauma and pulmonary inflammation are thought to be the most important predisposing factors of chronic lung disease (CLD), a major complication of prematurity. A new option in patient‐triggered ventilation (PTV), the volume guarantee (VG), a volume‐targeted ventilation, seems to be a promising approach in reducing the risk of CLD, by limiting lung inflammatory injury and volutrauma. Our aim was to evaluate lung inflammatory response in preterm infants with respiratory distress syndrome (RDS), mechanically ventilated with and without VG, as measured by proinflammatory cytokines (IL‐6, IL‐8, and TNF‐α) in tracheobronchial aspirate (TA) fluid. Fifty‐three preterm infants (GA = 25–32 weeks) with RDS were randomized at birth to be ventilated using pressure support ventilation (PSV) with VG (Vt = 5 ml/kg) (n = 30) and without VG (n = 23) (Draeger Babylog 8000 Plus, 5.n). IL‐6, IL‐8, and TNF‐α were determined by ELISA in TA samples on days 1, 3, and 7 of life. We observed a significant difference (ANOVA) in IL‐8 and IL‐6 levels on day 3 between the two groups (P < 0.05), and an increasing significative trend in IL‐8 values in PSV group (P < 0.05). Mechanical ventilation lasted longer in the PSV group (12.3 ± 3 vs. 8.8 ± 3 days) (P = no significance). In conclusion, these preliminary data suggest a role for volume‐targeted ventilatory strategy in reducing acute inflammatory response in preterm infants with RDS. Further studies are required in order to define whether this ventilatory strategy prevents lung injury. Pediatr Pulmonol. 2004; 37:510–514. © 2004 Wiley‐Liss, Inc.

Từ khóa


Tài liệu tham khảo

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Pediatric Pulmonology

Tập 37 Số 6

510-514

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