Injury and inflammation from resuscitation of the preterm infant

Neonatology. 2008;94(3):190-6. doi: 10.1159/000143721. Epub 2008 Oct 2.


We review information about how the preterm lung can be injured with the initiation of mechanical ventilation at birth. Although multiple variables such as pressure, tidal volume, positive end expiratory pressure, and the gas used for ventilation may contribute to the injury, the relative contribution of each is not known. Recent studies demonstrate that injury caused by initial high tidal volume is amplified by subsequent mechanical ventilation. A model for gas inflation of the fluid-filled lung may explain why even low tidal volumes may injure the preterm lung, and why the injury may initially occur to the small airways. Ventilation strategies that minimize injury need to be developed.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Asphyxia Neonatorum / therapy*
  • Humans
  • Infant, Newborn
  • Infant, Premature
  • Lung Compliance
  • Lung Injury / etiology*
  • Lung Injury / pathology
  • Pneumonia / etiology*
  • Pneumonia / pathology
  • Positive-Pressure Respiration
  • Pulmonary Surfactants / administration & dosage
  • Pulmonary Surfactants / adverse effects
  • Respiration, Artificial / adverse effects*
  • Respiration, Artificial / methods
  • Resuscitation / adverse effects*
  • Resuscitation / methods
  • Tidal Volume


  • Pulmonary Surfactants