Neonatal ventilation

Preventing ventilation-induced lung injury and bronchopulmonary dysplasia is an important goal in the care of ventilated neonates. Recently, there have been tremendous efforts to improve ventilation strategies, which aim at ventilating with a ‘protective’ and ‘open-lung’ strategy. Several different ventilation modes are now available, but it is important to note that, with regard to the neonatal pulmonary and neural outcome, there is still no clear evidence as to the superiority of one ventilation mode over another. Clinicians should bear in mind that any ventilation mode used to ventilate a neonate should be accompanied by real-time pulmonary monitoring to continuously adapt the ventilation strategy to the sudden changes in the respiratory mechanical properties of the lung. This article will describe the different ventilation modes available for neonates and highlight the importance of using a protective and open-lung ventilation strategy, even in the operating room.