Ventilation strategies for preventing oxidative stress-induced injury in preterm infants with respiratory disease: an update. (January 2016)

• Record Type: Journal Article
• Authors: Aversa, Salvatore; Marseglia, Lucia; Manti, Sara; D'Angelo, Gabriella; Cuppari, Caterina; David, Antonio; Chirico, Gaetano; Gitto, Eloisa
• Is Part Of: Paediatric respiratory reviews. Volume 17(2016)
• Page Start: 71
• Page End: 79
• Publication Date: 2016-01
• Subjects: SaO2 arterial oxygen saturation -- A/C assisted/controlled -- BPD bronchopulmonary dysplasia -- CAT catalase -- CTGF connective tissue growth factor -- CPAP continuous positive airway pressure -- CMV conventional mechanical ventilation -- CYR61 cysteine rich-61 -- DNA deoxyribonucleic acid -- EGR1 early growth response 1 -- ELBW extremely low-birth-weight -- FiO2 fraction of inspired oxygen -- GA gestational age -- VG volume guarantee -- HFOV high frequency oscillatory ventilation -- H2O2 hydrogen peroxide -- IVH intraventricular hemorrhage -- NIPPV nasal intermittent positive pressure ventilation -- NO nitric oxide -- NOS nitric oxide synthase -- NO2 nitrogen dioxide -- paCO2 partial pressure of carbon dioxide -- PO2 partial pressure of oxygen -- PDA patent ductus arteriosus -- PVL periventricular leukomalacia -- PPHN persistent pulmonary hypertension of the newborn -- PUPLs polyunsaturated phospholipids -- PEEP positive end-expiratory pressure -- PLV Pressure-limited ventilation -- PSV pressure support ventilation -- RNS reactive nitrogen species -- ROS reactive oxygen species -- ROP retinopathy of prematurity -- SOD superoxide dismutase -- SP surfactant protein -- SLI sustained lung inflation -- SIMV synchronized intermittent mandatory ventilation -- VT Tidal volume -- VTV volume-targeted ventilation; oxygen -- oxidative stress -- preterm newborn -- lung -- ventilation.; Pediatric respiratory diseases -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Respiratory Therapy -- Periodicals; Child -- Periodicals; Appareil respiratoire -- Infections, chez l'enfant -- Périodiques; Appareil respiratoire -- Maladies, chez l'enfant -- Périodiques; 618.922
• DOI: 10.1016/j.prrv.2015.08.015
• Languages: English
• ISSNs: 1526-0542

Abstract

Summary: Reactive oxygen and nitrogen species are produced by several inflammatory and structural cells of the airways. The lungs of preterm newborns are susceptible to oxidative injury induced by both reactive oxygen and nitrogen species. Increased oxidative stress and imbalance in antioxidant enzymes may play a role in the pathogenesis of inflammatory pulmonary diseases. Preterm infants are frequently exposed to high oxygen concentrations, infections or inflammation; they have reduced antioxidant defense and high free iron levels which enhance toxic radical generation. Multiple ventilation strategies have been studied to reduce injury and improve outcomes in preterm infants. Using lung protective strategies, there is the need to reach a compromise between satisfaction of gas exchange and potential toxicities related to over-distension, derecruitment of lung units and high oxygen concentrations. In this review, the authors summarize scientific evidence concerning oxidative stress as it relates to resuscitation in the delivery room and to the strategies of ventilation.