Seminars in perinatology最新文献

英文中文

Hemodynamics during noninvasive ventilation in neonates 新生儿无创通气期间的血流动力学。

IF 3.2 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Seminars in perinatology

Pub Date : 2025-08-01 DOI: 10.1016/j.semperi.2025.152065

Vidhi Jhaveri, Satyan Lakshminrusimha, Yogen Singh

Noninvasive ventilation (NIV) is increasingly used in neonatal care to reduce lung injury and improve respiratory outcomes. However, its effects on cardiovascular function and cardiopulmonary interactions, particularly in preterm neonates, remain unclear. This paper reviews the hemodynamic changes associated with NIV and provides an overview of how NIV influences cardiac preload, pulmonary vascular resistance, ventricular output, and systemic blood flow. NIV also affects these parameters in different ways in neonates with compromised cardiovascular stability, such as those with persistent pulmonary hypertension, patent ductus arteriosus and systemic hypotension. The synthesis of current evidence underscores that optimizing NIV requires careful titration of ventilatory parameters and highlights the potential role of targeted echocardiography and other clinical monitoring tools in guiding individualized management strategies. This review emphasizes the need for a nuanced approach that balances respiratory support with hemodynamic stability and calls for further research to establish best practices for the safe and effective use of NIV in neonates with hemodynamic compromise.

无创通气（NIV）越来越多地用于新生儿护理，以减少肺损伤和改善呼吸结局。然而，其对心血管功能和心肺相互作用的影响，特别是对早产儿的影响尚不清楚。本文回顾了与NIV相关的血流动力学变化，并概述了NIV如何影响心脏预负荷、肺血管阻力、心室输出量和全身血流。对于心血管稳定性受损的新生儿，如持续性肺动脉高压、动脉导管未闭和全身性低血压，NIV也会以不同的方式影响这些参数。综合目前的证据强调，优化NIV需要仔细滴定通气参数，并强调有针对性的超声心动图和其他临床监测工具在指导个体化管理策略中的潜在作用。这篇综述强调需要一种微妙的方法来平衡呼吸支持和血液动力学稳定性，并呼吁进一步的研究来建立安全有效地使用NIV在血液动力学受损的新生儿中的最佳做法。

{"title":"Hemodynamics during noninvasive ventilation in neonates","authors":"Vidhi Jhaveri, Satyan Lakshminrusimha, Yogen Singh","doi":"10.1016/j.semperi.2025.152065","DOIUrl":"10.1016/j.semperi.2025.152065","url":null,"abstract":"<div><div>Noninvasive ventilation (NIV) is increasingly used in neonatal care to reduce lung injury and improve respiratory outcomes. However, its effects on cardiovascular function and cardiopulmonary interactions, particularly in preterm neonates, remain unclear. This paper reviews the hemodynamic changes associated with NIV and provides an overview of how NIV influences cardiac preload, pulmonary vascular resistance, ventricular output, and systemic blood flow. NIV also affects these parameters in different ways in neonates with compromised cardiovascular stability, such as those with persistent pulmonary hypertension, patent ductus arteriosus and systemic hypotension. The synthesis of current evidence underscores that optimizing NIV requires careful titration of ventilatory parameters and highlights the potential role of targeted echocardiography and other clinical monitoring tools in guiding individualized management strategies. This review emphasizes the need for a nuanced approach that balances respiratory support with hemodynamic stability and calls for further research to establish best practices for the safe and effective use of NIV in neonates with hemodynamic compromise.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 5","pages":"Article 152065"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Non-invasive ventilation of preterm infants in the delivery room 产房早产儿的无创通气。

IF 3.2 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Seminars in perinatology

Pub Date : 2025-08-01 DOI: 10.1016/j.semperi.2025.152080

J. Dekker , S.B. Hooper , A.B. te Pas

The approach to respiratory support in preterm infants at birth has shifted from invasive to non-invasive techniques. The effectiveness of non-invasive respiratory support relies on a good mask seal and maintaining a patent airway, but this appears to be more challenging than initially thought. The force applied to the mask must be sufficient for a good mask seal to reduce leak, but too much pressure on the face mask can inhibit breathing. Also, airway obstruction due to a closed glottis can prevent the lungs from being effectively ventilated. It is now evident that spontaneous breathing is essential for a patent airway, with oxygenation playing a key role in stimulating breathing. This can be improved by increasing the surface area available for gas exchange with appropriate continuous positive airway pressures (CPAP) and/or increasing the inspired oxygen concentration. Tactile stimulation can help promote spontaneous breathing, which promotes lung aeration and gas exchange potential, thereby improving oxygenation, which further improves the overall effectiveness of non-invasive respiratory support.

早产儿出生时的呼吸支持方法已经从侵入性技术转变为非侵入性技术。非侵入性呼吸支持的有效性依赖于良好的面罩密封和保持气道通畅，但这似乎比最初想象的更具挑战性。施加在口罩上的力必须足以使口罩密封良好，以减少泄漏，但施加在口罩上的压力过大会抑制呼吸。此外，由于声门关闭导致的气道阻塞会阻止肺部有效通风。现在很明显，自发呼吸对气道通畅至关重要，氧合在刺激呼吸中起着关键作用。这可以通过适当的持续气道正压（CPAP）增加可用于气体交换的表面积和/或增加吸入氧浓度来改善。触觉刺激有助于促进自发呼吸，促进肺通气和气体交换电位，从而改善氧合，进一步提高无创呼吸支持的整体效果。

引用次数: 0

Optimizing synchronized non-invasive support: Clinical management guidelines for non-invasive neurally adjusted ventilatory assist 优化同步无创支持：无创神经调节通气辅助的临床管理指南

IF 3.2 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Seminars in perinatology

Pub Date : 2025-08-01 DOI: 10.1016/j.semperi.2025.152036

Kimberly Firestone , Howard Stein

Neurally Adjusted Ventilatory Assist (NAVA) is an innovative ventilation mode that empowers patients to control both the timing and level of ventilatory support. By utilizing the electrical activity of the diaphragm (Edi) as the control signal, NAVA enables synchronized non-invasive ventilation (NIV-NAVA) even in the presence of leaks, while also providing continuous monitoring of the patient's respiratory pattern and drive. NIV-NAVA offers several advantages compared to conventional non-invasive ventilation, including enhanced patient-ventilator interaction and synchrony, reliable respiratory monitoring, and self-regulation of respiratory support. These features make NIV-NAVA theoretically ideal for providing effective and tailored non-invasive support to newborns with respiratory insufficiency. In clinical practice, NIV-NAVA has been successfully employed in neonates to prevent intubation, facilitate early extubation, and deliver nasal continuous positive airway pressure in a novel manner. Set up and management of NAVA has unique differences from conventional ventilation and an understanding of these is essential for successful NAVA ventilation. The efficacy of this approach in neonatal care is supported by numerous studies and clinical experiences with NIV-NAVA, demonstrating its potential to improve outcomes for infants with respiratory challenges

神经调节通气辅助（NAVA）是一种创新的通气模式，使患者能够控制通气支持的时间和水平。通过利用隔膜（Edi）的电活动作为控制信号，即使在存在泄漏的情况下，NAVA也可以实现同步无创通气（NIV-NAVA），同时还可以连续监测患者的呼吸模式和驱动。与传统的无创通气相比，NIV-NAVA具有几个优势，包括增强患者与呼吸机的相互作用和同步性、可靠的呼吸监测和呼吸支持的自我调节。这些特点使得NIV-NAVA在理论上非常适合为呼吸功能不全的新生儿提供有效和量身定制的非侵入性支持。在临床实践中，NIV-NAVA已成功应用于新生儿预防插管，促进早期拔管，并以一种新颖的方式提供鼻腔持续气道正压。NAVA的设置和管理与传统通气有独特的区别，了解这些对于成功的NAVA通气至关重要。这种方法在新生儿护理中的有效性得到了大量NIV-NAVA研究和临床经验的支持，证明了其改善呼吸困难婴儿预后的潜力

{"title":"Optimizing synchronized non-invasive support: Clinical management guidelines for non-invasive neurally adjusted ventilatory assist","authors":"Kimberly Firestone , Howard Stein","doi":"10.1016/j.semperi.2025.152036","DOIUrl":"10.1016/j.semperi.2025.152036","url":null,"abstract":"<div><div>Neurally Adjusted Ventilatory Assist (NAVA) is an innovative ventilation mode that empowers patients to control both the timing and level of ventilatory support. By utilizing the electrical activity of the diaphragm (Edi) as the control signal, NAVA enables synchronized non-invasive ventilation (NIV-NAVA) even in the presence of leaks, while also providing continuous monitoring of the patient's respiratory pattern and drive. NIV-NAVA offers several advantages compared to conventional non-invasive ventilation, including enhanced patient-ventilator interaction and synchrony, reliable respiratory monitoring, and self-regulation of respiratory support. These features make NIV-NAVA theoretically ideal for providing effective and tailored non-invasive support to newborns with respiratory insufficiency. In clinical practice, NIV-NAVA has been successfully employed in neonates to prevent intubation, facilitate early extubation, and deliver nasal continuous positive airway pressure in a novel manner. Set up and management of NAVA has unique differences from conventional ventilation and an understanding of these is essential for successful NAVA ventilation. The efficacy of this approach in neonatal care is supported by numerous studies and clinical experiences with NIV-NAVA, demonstrating its potential to improve outcomes for infants with respiratory challenges</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 5","pages":"Article 152036"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Extending CPAP in stable preterm infants to increase lung growth and development as measured by pulmonary function testing 通过肺功能测试，延长稳定早产儿的CPAP以促进肺生长发育。

IF 3.2 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Seminars in perinatology

Pub Date : 2025-08-01 DOI: 10.1016/j.semperi.2025.152059

Rachna R. Mamidi , Cindy T. McEvoy

Nasal continuous positive airway pressure (CPAP) is the standard of care for the acute management of preterm infants with respiratory distress, however, the optimal duration of CPAP in stable preterm infants is unknown. In utero, preclinical, and clinical data support the premise that mechanical stretch from CPAP can increase lung growth and development. This paper will review data to support this premise, studies examining weaning infants off CPAP, the current practices in the United States regarding CPAP application and duration, and clinical studies of the association of CPAP duration and subsequent lung growth and development. Pulmonary function testing will be presented as an important outcome throughout these trials.

鼻持续气道正压通气（CPAP）是急性呼吸窘迫早产儿的标准治疗方法，然而，稳定型早产儿CPAP的最佳持续时间尚不清楚。子宫内、临床前和临床数据支持CPAP机械拉伸可以促进肺生长发育的前提。本文将回顾支持这一前提的数据、检查断奶婴儿CPAP的研究、美国目前关于CPAP应用和持续时间的实践，以及CPAP持续时间与随后肺部生长发育之间关系的临床研究。在这些试验中，肺功能测试将作为一个重要的结果。

引用次数: 0

Update on nasal high frequency oscillatory ventilation: A living review 鼻高频振荡通气的最新进展：动态回顾。

IF 3.2 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Seminars in perinatology

Pub Date : 2025-08-01 DOI: 10.1016/j.semperi.2025.152056

Daniele De Luca , Costanza Neri , Roberta Centorrino (Attending Neonatologist)

Non-invasive high-frequency oscillatory ventilation (NHFOV) is the main non-conventional ventilatory mode used in newborn infants. NHFOV has been spreading, while knowledge about its physiology, mechanics and clinical application has increased overtime. This is to be considered as a living review, since we here update the knowledge that was originally summarized in a previously published review. We first focus on physiology of such a complex respiratory support technique with practical data on interfaces, patient-ventilator interaction and devices to provide NHFOV. We then move to the evidence-based review of parallel randomized clinical trial published so far. We provide both qualitative and quantitative synthesis of results for the two commonest outcomes, i.e. need for intubation and invasive ventilation and CO₂ elimination. We also provide our protocol to use NHFOV together with other respiratory support modes and we provide suggestions on parameters boundaries and identification of patients to treat. We finally identify still open questions needing future research to optimize the use of NHFOV In preterm infants.

无创高频振荡通气（NHFOV）是新生儿主要的非常规通气方式。随着对其生理学、力学和临床应用的了解不断增加，NHFOV一直在传播。这将被视为一篇活的综述，因为我们在这里更新了先前发表的综述中最初总结的知识。我们首先将重点放在这种复杂的呼吸支持技术的生理学上，并提供有关接口，患者-呼吸机相互作用和提供NHFOV的设备的实际数据。然后我们转到目前为止发表的平行随机临床试验的循证评价。我们提供了两种最常见结果的定性和定量综合结果，即需要插管和有创通气和CO2消除。我们还提出了将NHFOV与其他呼吸支持模式联合使用的方案，并对参数边界和治疗患者的识别提出了建议。我们最终确定了需要进一步研究的开放性问题，以优化NHFOV在早产儿中的应用。

{"title":"Update on nasal high frequency oscillatory ventilation: A living review","authors":"Daniele De Luca , Costanza Neri , Roberta Centorrino (Attending Neonatologist)","doi":"10.1016/j.semperi.2025.152056","DOIUrl":"10.1016/j.semperi.2025.152056","url":null,"abstract":"<div><div>Non-invasive high-frequency oscillatory ventilation (NHFOV) is the main non-conventional ventilatory mode used in newborn infants. NHFOV has been spreading, while knowledge about its physiology, mechanics and clinical application has increased overtime. This is to be considered as a living review, since we here update the knowledge that was originally summarized in a previously published review<em>.</em> We first focus on physiology of such a complex respiratory support technique with practical data on interfaces, patient-ventilator interaction and devices to provide NHFOV. We then move to the evidence-based review of parallel randomized clinical trial published so far. We provide both qualitative and quantitative synthesis of results for the two commonest outcomes, i.e. need for intubation and invasive ventilation and CO<sub>2</sub> elimination. We also provide our protocol to use NHFOV together with other respiratory support modes and we provide suggestions on parameters boundaries and identification of patients to treat. We finally identify still open questions needing future research to optimize the use of NHFOV In preterm infants.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 5","pages":"Article 152056"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Non-invasive respiratory support paired with minimally invasive surfactant therapy in preterm infants 无创呼吸支持与微创表面活性剂治疗在早产儿中的应用。

IF 3.2 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Seminars in perinatology

Pub Date : 2025-08-01 DOI: 10.1016/j.semperi.2025.152092

Peter A. Dargaville , Emily K. Cripps

Non-invasive ventilation (NIV) commenced soon after birth is highly effective in providing mechanical respiratory support for preterm infants with respiratory distress syndrome (RDS). However, NIV alone frequently fails to provide adequate respiratory support for infants with more significant respiratory compromise due to RDS. Without an endotracheal tube as the conduit to administer exogenous surfactant in such cases, less invasive approaches to surfactant delivery have emerged, with those involving the use of a thin catheter (termed minimally invasive surfactant therapy, MIST) now in the ascendancy. The application of MIST with NIV support continuing allows spontaneous breathing to be harnessed for optimal surfactant dispersal to the distal airspaces. Here we examine the importance of this pairing of NIV with MIST and review the evidence for optimization of NIV before, during and after delivery of surfactant. All evidence points to NIV and MIST being an elegant and synergistic pairing of two therapies for optimal respiratory support of preterm infants in early life. Whilst much of the clinical trial data regarding the pairing of NIV and MIST relates to application of standard continuous positive airway pressure, non-invasive positive pressure ventilation in its various forms may offer additional advantage, and further studies are warranted.

出生后不久开始的无创通气（NIV）在为患有呼吸窘迫综合征（RDS）的早产儿提供机械呼吸支持方面非常有效。然而，单独使用NIV往往不能为因RDS而出现更严重呼吸损害的婴儿提供足够的呼吸支持。在这种情况下，如果没有气管内管作为输注外源性表面活性剂的导管，就出现了侵入性较小的表面活性剂输注方法，其中包括使用细导管（称为微创表面活性剂治疗，MIST）。MIST与NIV支持的持续应用允许利用自发呼吸来优化表面活性剂分散到远端空气空间。在这里，我们研究了这种NIV与MIST配对的重要性，并回顾了在表面活性剂交付之前，期间和之后优化NIV的证据。所有证据表明，NIV和MIST是两种治疗方法的优雅和协同配对，可在生命早期为早产儿提供最佳的呼吸支持。虽然关于NIV和MIST配对的许多临床试验数据涉及标准持续气道正压通气的应用，但各种形式的无创正压通气可能提供额外的优势，并且需要进一步的研究。

{"title":"Non-invasive respiratory support paired with minimally invasive surfactant therapy in preterm infants","authors":"Peter A. Dargaville , Emily K. Cripps","doi":"10.1016/j.semperi.2025.152092","DOIUrl":"10.1016/j.semperi.2025.152092","url":null,"abstract":"<div><div>Non-invasive ventilation (NIV) commenced soon after birth is highly effective in providing mechanical respiratory support for preterm infants with respiratory distress syndrome (RDS). However, NIV alone frequently fails to provide adequate respiratory support for infants with more significant respiratory compromise due to RDS. Without an endotracheal tube as the conduit to administer exogenous surfactant in such cases, less invasive approaches to surfactant delivery have emerged, with those involving the use of a thin catheter (termed minimally invasive surfactant therapy, MIST) now in the ascendancy. The application of MIST with NIV support continuing allows spontaneous breathing to be harnessed for optimal surfactant dispersal to the distal airspaces. Here we examine the importance of this pairing of NIV with MIST and review the evidence for optimization of NIV before, during and after delivery of surfactant. All evidence points to NIV and MIST being an elegant and synergistic pairing of two therapies for optimal respiratory support of preterm infants in early life. Whilst much of the clinical trial data regarding the pairing of NIV and MIST relates to application of standard continuous positive airway pressure, non-invasive positive pressure ventilation in its various forms may offer additional advantage, and further studies are warranted.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 5","pages":"Article 152092"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advances in management of noninvasive ventilation for preterm infants 早产儿无创通气治疗的进展。

IF 3.2 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Seminars in perinatology

Pub Date : 2025-08-01 DOI: 10.1016/j.semperi.2025.152060

Manoj Biniwale, Rangasamy Ramanathan

Providing most appropriate noninvasive ventilation (NIV) for preterm infants remains priority in neonatal intensive care units. Several newer modes of ventilation have evolved including continuous positive airway pressure, nasal intermittent positive pressure ventilation and noninvasive high frequency ventilation to meet patients’ demands. Advanced level of monitoring is performed while patients are receiving NIV for optimization of the respiratory support. Point of care lung ultrasound and electrical impedance tomography are the newer tools that give insights towards aeration of the lungs. Pulmonary near infrared spectroscopy, electromyography of the diaphragm and advanced techniques of noninvasive pulmonary function testing provide data focusing on the performance of lungs. The hybrid modalities of ventilators used often in adults are needed in neonates to provide on demand individualized level of noninvasive respiratory support. Automated oxygen adjustment, inhaled nitric oxide and heliox can be benefcial when successfully provided through NIV. Delivery room NIV has a strong potential to improve neonatal outcomes. Further research should be focused taking into consideration physiologic needs and applying customized approach to meet patient's demands. Artificial intelligence leading to precision treatment is the way forward for providing individualized respiratory support for newborn infants

为早产儿提供最适当的无创通气（NIV）仍然是新生儿重症监护病房的优先事项。一些更新的通气模式已经发展，包括持续气道正压通气，鼻间歇正压通气和无创高频通气，以满足患者的需求。在患者接受无创通气时进行高级水平的监测，以优化呼吸支持。护理点肺超声和电阻抗断层扫描是较新的工具，可以深入了解肺部通气。肺近红外光谱，膈肌电图和先进的无创肺功能测试技术提供了关注肺性能的数据。通常在成人中使用的混合模式呼吸机需要在新生儿中提供个性化的无创呼吸支持。当成功地通过NIV提供时，自动氧气调节，吸入一氧化氮和helix是有益的。产房NIV在改善新生儿结局方面具有很大的潜力。进一步的研究应集中在考虑生理需求和应用个性化的方法来满足患者的需求。人工智能导致的精准治疗是为新生儿提供个性化呼吸支持的前进方向。

{"title":"Advances in management of noninvasive ventilation for preterm infants","authors":"Manoj Biniwale, Rangasamy Ramanathan","doi":"10.1016/j.semperi.2025.152060","DOIUrl":"10.1016/j.semperi.2025.152060","url":null,"abstract":"<div><div>Providing most appropriate noninvasive ventilation (NIV) for preterm infants remains priority in neonatal intensive care units. Several newer modes of ventilation have evolved including continuous positive airway pressure, nasal intermittent positive pressure ventilation and noninvasive high frequency ventilation to meet patients’ demands. Advanced level of monitoring is performed while patients are receiving NIV for optimization of the respiratory support. Point of care lung ultrasound and electrical impedance tomography are the newer tools that give insights towards aeration of the lungs. Pulmonary near infrared spectroscopy, electromyography of the diaphragm and advanced techniques of noninvasive pulmonary function testing provide data focusing on the performance of lungs. The hybrid modalities of ventilators used often in adults are needed in neonates to provide on demand individualized level of noninvasive respiratory support. Automated oxygen adjustment, inhaled nitric oxide and heliox can be benefcial when successfully provided through NIV. Delivery room NIV has a strong potential to improve neonatal outcomes. Further research should be focused taking into consideration physiologic needs and applying customized approach to meet patient's demands. Artificial intelligence leading to precision treatment is the way forward for providing individualized respiratory support for newborn infants</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 5","pages":"Article 152060"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

NIPPV vs CPAP: Lessons from meta-analyses NIPPV与CPAP：来自荟萃分析的教训。

IF 3.2 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Seminars in perinatology

Pub Date : 2025-08-01 DOI: 10.1016/j.semperi.2025.152062

Marc-Olivier Deguise , Brigitte Lemyre

Care of the extremely premature infant has been in constant state of re-evaluation as the population, technologies and knowledge continue to evolve. A growing population of extremely low gestational age neonates (ELGAN - <28 weeks) and “nanopremies” (<24 weeks) are undergoing successful resuscitation, stabilization, and intensive care leading to improved survival. Respiratory care is the cornerstone of ELGAN management, as their lungs are at a critical stage of development. The lifesaving intensive care they require can lead to various injurious stimuli making them prone to bronchopulmonary dysplasia (BPD). Non-invasive ventilation (NIV), including continuous positive airway pressure ventilation (CPAP) and nasal intermittent positive pressure ventilation (NIPPV) has evolved and can appropriately support premature infants’ breathing, while limiting the invasiveness and associated complications of mechanical ventilation. This review focuses on our current understanding, knowledge and evidence gathered via meta-analysis on these two modes of NIV in preterm infants, when used either as primary intent respiratory support post-birth or following extubation. We will summarize the current data of recent meta-analyses, their pitfalls, and the remaining questions to be addressed by future research to optimize the use of these modes of respiratory support in preterm infants most at risk for BPD.

随着人口、技术和知识的不断发展，对极早产儿的护理一直处于不断重新评估的状态。极低胎龄新生儿人口的增长（ELGAN -）

{"title":"NIPPV vs CPAP: Lessons from meta-analyses","authors":"Marc-Olivier Deguise , Brigitte Lemyre","doi":"10.1016/j.semperi.2025.152062","DOIUrl":"10.1016/j.semperi.2025.152062","url":null,"abstract":"<div><div>Care of the extremely premature infant has been in constant state of re-evaluation as the population, technologies and knowledge continue to evolve. A growing population of extremely low gestational age neonates (ELGAN - <28 weeks) and “nanopremies” (<24 weeks) are undergoing successful resuscitation, stabilization, and intensive care leading to improved survival. Respiratory care is the cornerstone of ELGAN management, as their lungs are at a critical stage of development. The lifesaving intensive care they require can lead to various injurious stimuli making them prone to bronchopulmonary dysplasia (BPD). Non-invasive ventilation (NIV), including continuous positive airway pressure ventilation (CPAP) and nasal intermittent positive pressure ventilation (NIPPV) has evolved and can appropriately support premature infants’ breathing, while limiting the invasiveness and associated complications of mechanical ventilation. This review focuses on our current understanding, knowledge and evidence gathered via meta-analysis on these two modes of NIV in preterm infants, when used either as primary intent respiratory support post-birth or following extubation. We will summarize the current data of recent meta-analyses, their pitfalls, and the remaining questions to be addressed by future research to optimize the use of these modes of respiratory support in preterm infants most at risk for BPD.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 5","pages":"Article 152062"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of non-invasive ventilation on Bronchopulmonary Dysplasia 无创通气对支气管肺发育不良的影响。

IF 3.2 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Seminars in perinatology

Pub Date : 2025-08-01 DOI: 10.1016/j.semperi.2025.152061

Vikramaditya Dumpa , Indirapriya Avulakunta , Vineet Bhandari

Bronchopulmonary dysplasia (BPD) is a major complication of prematurity, leading to long-term pulmonary morbidity. Invasive mechanical ventilation (IMV) is associated with ventilator-induced lung injury, oxygen toxicity, and inflammation, all contributing to BPD pathogenesis. Non-invasive ventilation (NIV) has emerged as a key strategy to reduce the incidence and severity of BPD. We examine the role of various NIV strategies in the respiratory management of premature infants. We discuss the common forms of NIV, including nasal continuous positive airway pressure, nasal intermittent positive pressure ventilation, bilevel positive airway pressure, high-flow nasal cannula, and nasal high-frequency ventilation, with a focus on their mechanisms of action, benefits, and limitations. Several studies have demonstrated that early and appropriate NIV use can reduce the incidence of BPD, improve oxygenation, and promote lung growth. However, NIV is not without challenges, including patient selection, the timing of initiation, and potential difficulties in achieving adequate ventilation, especially in extremely low birth weight neonates. Adjunctive therapies such as early surfactant therapy, less invasive surfactant administration, and caffeine may enhance the effectiveness of NIV. In conclusion, NIV is a promising approach to decreasing BPD, yet its effectiveness relies on proper clinical application and integration with other therapies to maximize its benefits.

支气管肺发育不良（BPD）是早产的主要并发症，可导致长期肺部疾病。有创机械通气（IMV）与呼吸机诱导的肺损伤、氧毒性和炎症有关，这些都与BPD的发病机制有关。无创通气（NIV）已成为降低BPD发病率和严重程度的关键策略。我们研究了各种NIV策略在早产儿呼吸管理中的作用。我们讨论了常见的NIV形式，包括鼻持续气道正压通气、鼻间歇正压通气、双水平气道正压通气、高流量鼻插管和鼻高频通气，并重点讨论了它们的作用机制、益处和局限性。一些研究表明，早期和适当使用NIV可以降低BPD的发病率，改善氧合，促进肺生长。然而，NIV并非没有挑战，包括患者选择，启动时间，以及实现充分通气的潜在困难，特别是在极低出生体重的新生儿中。辅助治疗，如早期表面活性剂治疗，较少侵入性的表面活性剂施用和咖啡因可提高NIV的有效性。总之，NIV是一种很有前途的降低BPD的方法，但其有效性取决于适当的临床应用和与其他治疗方法的结合，以最大限度地提高其效益。

{"title":"Effect of non-invasive ventilation on Bronchopulmonary Dysplasia","authors":"Vikramaditya Dumpa , Indirapriya Avulakunta , Vineet Bhandari","doi":"10.1016/j.semperi.2025.152061","DOIUrl":"10.1016/j.semperi.2025.152061","url":null,"abstract":"<div><div>Bronchopulmonary dysplasia (BPD) is a major complication of prematurity, leading to long-term pulmonary morbidity. Invasive mechanical ventilation (IMV) is associated with ventilator-induced lung injury, oxygen toxicity, and inflammation, all contributing to BPD pathogenesis. Non-invasive ventilation (NIV) has emerged as a key strategy to reduce the incidence and severity of BPD. We examine the role of various NIV strategies in the respiratory management of premature infants. We discuss the common forms of NIV, including nasal continuous positive airway pressure, nasal intermittent positive pressure ventilation, bilevel positive airway pressure, high-flow nasal cannula, and nasal high-frequency ventilation, with a focus on their mechanisms of action, benefits, and limitations. Several studies have demonstrated that early and appropriate NIV use can reduce the incidence of BPD, improve oxygenation, and promote lung growth. However, NIV is not without challenges, including patient selection, the timing of initiation, and potential difficulties in achieving adequate ventilation, especially in extremely low birth weight neonates. Adjunctive therapies such as early surfactant therapy, less invasive surfactant administration, and caffeine may enhance the effectiveness of NIV. In conclusion, NIV is a promising approach to decreasing BPD, yet its effectiveness relies on proper clinical application and integration with other therapies to maximize its benefits.</div></div>","PeriodicalId":21761,"journal":{"name":"Seminars in perinatology","volume":"49 5","pages":"Article 152061"},"PeriodicalIF":3.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evolution of neonatal noninvasive ventilation 新生儿无创通气的发展

IF 3.2 3区医学 Q1 OBSTETRICS & GYNECOLOGY

Seminars in perinatology

Pub Date : 2025-08-01 DOI: 10.1016/j.semperi.2025.152079

Manoj Biniwale

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Seminars in perinatology

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀