Respiratory distress syndrome (RDS) describes any change to frequency and/or quality of breathing pattern in newborns. Breathing rate < 60/minute (can be up to 70/min during the first hours of life and sets to around 40/min) is considered physiologic and newborn should not display any signs of increased work of breathing…
Bronchopulmonary dysplasia (BPD) or chronic lung disease (CLD) is a typical disease of extremely low birth weight infants (ELBW; birth weight < 1000g) who experienced adverse lung development but were not necessarily exposed to mechanical ventilation (“new” BPD). Originally, BPD was linked to acute respiratory failure (of various origins) and prolonged mechanical…
Apneas represent another important group of respiratory/ventilation dysfunctions in newborns (apart from perinatal asphyxia and respiratory distress syndrome). They are generally defined as a cessation of breathing movements and air flow for more than 20 seconds, thus often being accompanied by desaturation and bradycardia. Spontaneous breathing causes water in lungs to be resorbed into blood and…
We should attempt to maintain normoxemic oxygenation in order to prevent hypoxic injury (mainly in the cerebral tissue). On the other hand, oxygen should be carefully titrated to newborns, especially preterm, due to the negative effects associated with its overuse (reactive oxygen species = ROS). Hyperoxia induces the production of oxygen radicals that subsequently trigger…
Persistent pulmonary hypertension of newborns (PPHN) is characterized by postnatally persistent vasoconstriction of the pulmonary arteries, causing increased pulmonary arterial resistance. As a consequence, right-left shunting (extra-pulmonary shunts) occurs through foramen ovale apertum (FOA) and patent ductus arteriosus (PDA) with resultant hypoxemia. Also, pulmonary arteries in neonates are more prone to vasoconstriction than in adults. There is primary (impaired development…
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