MECHANICAL VENTILATION OF PREMATURE NEONA TES

Better understanding of respiratory physiology and progress in ventila tor technology have contributed to improved mortality and morbidity of premature neonates. Yet, pulmonary complications remain high and ther e is no consensus about the optimal regimen of mechanical ventilation. We report our satisfactory 10-year experience with conventional mecha nical ventilation based on a relatively low incidence of pulmonary bar otrauma. The introduction of surfactant has facilitated the ventilator y management of premature neonates since the usually rapid improvement of the acute lung disease after surfactant administration allows for earlier weaning from mechanical ventilation. However, our own results and the results from most surfactant studies show no significant reduc tion in the incidence of intraventricular haemorrhage. Thus, though me chanical ventilation and surfactant administration are milestones in n eonatal therapeutic management, the problems encountered in very low b irth weight neonates both with respect to mortality and morbidity have not been generally solved and underline the role of optimal perinatal management.