Respiratory support of infants born at 22-24 weeks of gestational age

Mikael Norman; Baldvin Jonsson; Linda Wallström; Richard Sindelar

doi:10.1016/j.siny.2022.101328

Respiratory support of infants born at 22-24 weeks of gestational age

Semin Fetal Neonatal Med. 2022 Apr;27(2):101328. doi: 10.1016/j.siny.2022.101328. Epub 2022 Apr 1.

Authors

Mikael Norman¹, Baldvin Jonsson², Linda Wallström³, Richard Sindelar³

Affiliations

¹ Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden; Department of Neonatal Medicine, S3:03 Norrbacka, Karolinska University Hospital, SE-171 76, Stockholm, Sweden. Electronic address: mikael.norman@ki.se.
² Department of Neonatal Medicine, S3:03 Norrbacka, Karolinska University Hospital, SE-171 76, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
³ Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Pediatrics, Uppsala University Hospital, SE-751 85, Uppsala, Sweden.

PMID: 35400604
DOI: 10.1016/j.siny.2022.101328

Abstract

Lung immaturity and acute respiratory failure are the major problems in the care of extremely preterm infants. Most infants with gestational age (GA) 22-24 weeks will need mechanical ventilation and many will depend on some type of respiratory support, invasive and non-invasive for extended periods. There is ongoing gap in knowledge regarding optimal respiratory support and applying strategies that are effective in more mature populations is not easy or even suitable because lung maturation differs in smaller infants. Better strategies on how to avoid lung damage and to promote growth and development of the immature lung are warranted since increased survival is accompanied by increasing rates of bronchopulmonary dysplasia and concerns over long-standing reductions in lung function. This review focuses on some aspects of respiratory care of infants born at 22-24 weeks of GA.

Keywords: Antenatal corticosteroids; Bronchopulmonary dysplasia; Extremely preterm infant; Mechanical ventilation; Neonatal resuscitation; Non-invasive respiratory support; Surfactant.

Publication types

Review
Research Support, Non-U.S. Gov't

MeSH terms

Bronchopulmonary Dysplasia* / etiology
Bronchopulmonary Dysplasia* / prevention & control
Gestational Age
Humans
Infant
Infant, Extremely Premature
Infant, Newborn
Lung
Respiration, Artificial / adverse effects
Respiratory Distress Syndrome, Newborn* / therapy