Volume ventilation in neonates

Preterm babies are born with immature airways and deficiency of surfactant and a compliant chest wall. This increases the work of breathing with a large proportion of extreme preterm babies requiring invasive ventilation through the endotracheal tube. The improvements in the uptake of antenatal steroids and better perinatal care allow a proportion of these preterm babies to be successfully managed non-invasively. Those ventilated are at risk of iatrogenic lung injury including ventilation induced lung injury. Synchronising the ventilation to the baby's breathing pattern and minimizing lung injury are crucial in reducing complications such as bronchopulmonary dysplasia and long term respiratory morbidity. Volume targeted ventilation in preterm babies has been evaluated in last two decades and is now standard of care. Meta-analysis of trials reports that it improves short-term outcomes to discharge and some complications of prematurity.