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Lung inflammation in preterm infants with respiratory distress syndrome: Effects of ventilation with different tidal volumes
Author(s) -
Lista Gianluca,
Castoldi Francesca,
Fontana Paola,
Reali Roberta,
Reggiani Alessandro,
Bianchi Silvia,
Compagi Gilberto
Publication year - 2006
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20363
Subject(s) - medicine , respiratory distress , ventilation (architecture) , lung , tidal volume , respiratory system , inflammation , respiratory disease , bronchopulmonary dysplasia , respiratory physiology , anesthesia , intensive care medicine , cardiology , pregnancy , gestational age , mechanical engineering , biology , engineering , genetics
Ventilation with an inappropriate tidal volume (Vt) triggers lung inflammation, an important predisposing factor of bronchopulmonary dysplasia. It still remains uncertain what the appropriate starting target Vt should be during the acute phase of respiratory distress syndrome (RDS). Our aim was to evaluate lung inflammation in preterm infants undergoing synchronized intermittent positive‐pressure ventilation (SIPPV) with two different tidal volumes Vt during the acute phase of RDS. Thirty preterm infants (gestational age, 25–32 weeks) with acute RDS were randomly assigned to be ventilated with Vt = 5ml/kg (n = 15) or Vt = 3 ml/kg (n = 15). Proinflammatory cytokines (interleukin‐6 (IL‐6), interleukin‐8 (IL‐8), and tumor necrosis factor (TNF)‐α) were determined in the tracheal aspirate on days 1, 3, and 7 of life. IL‐8 and TNF‐α levels collected on day 7 were significantly higher ( P < 0.05), and mechanical ventilation lasted longer in the group with Vt = 3 ml/kg (16.8 ± 4 vs. 9.2 ± 4 days; P = 0.05). In conclusion, our data show significantly higher lung inflammation in preterm infants ventilated with Vt = 3 ml/kg, suggesting a role for Vt = 5 ml/kg in reducing both inflammatory response during the acute phase of RDS and the length of ventilation. Whether the use of this starting Vt prevents bronchopulmonary dysplasia requires further study. Pediatr Pulmonol. © 2006 Wiley‐Liss, Inc.