The introduction of mechanical ventilation in the 1960s was one of the major new interventions in neonatology, which provided life-saving support for infants with respiratory failure. Along with other technologic advancements, such as the administration of antepartum corticosteroids and replacement surfactant therapy, mechanical ventilation has led to improved neonatal survival, especially for premature infants born less than 30 weeks gestation with immature lung function. (See "Incidence and mortality of the premature infant".)
Although mechanical ventilation can be life saving, it may cause chronic lung injury resulting in bronchopulmonary dysplasia (BPD), a major complication of prematurity. As a result, continued efforts have been focused upon development of new technology and strategies for neonatal ventilator care to maintain adequate gas exchange, but minimize lung damage. (See "Pathogenesis and clinical features of bronchopulmonary dysplasia".)
Neonatal ventilator care including the different types of mechanical ventilation and their advantages and disadvantages will be reviewed here.
Benefits — The principal benefits of neonatal mechanical ventilation during respiratory failure are as follows:
●Improve gas exchange, primarily by lung recruitment to improve ventilation/perfusion (V/Q) matching (see "Physiologic and pathophysiologic consequences of mechanical ventilation", section on 'Reduced shunt')