Lung protective strategies

In the recent decades, increasing proportion of extreme preterm neonates are surviving with the advances in neonatal care, use of continuous positive airway pressure, surfactant and improvement in ventilation equipments and strategies. However, large number of these infants are also at risk of respiratory morbidities of bronchpulmonary dysplasia (BPD). With the better understanding and improvements in equipments newer strategies are being employed to reduce the effects of mechanical ventilation on immature lung of preterm neonates. Effective use of antenatal steroids, appropriate delivery room management, surfactant administration, early use of noninvasive positive pressure ventilation, use of gentle ventilation along with patient triggered modes with permissive hypercapnia and prevention of hyperoxia have resulted in better outcomes in these at-risk neonates.