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Neonatal pulmonology: optimizing transition and lung function in preterm infants

Pediatric Research (2024)Cite this article

Dramatic advances in the optimization of neonatal respiratory function have been crucial in improving preterm infant survival. Commonly used adjuvant therapies aim to decrease long-term morbidities and mortality including systemic corticosteroids, caffeine, inhaled steroids, diuretics, surfactant, inhaled bronchodilators and improvemnt in ventilators. This series of papers highlights recent advances in neonatal pulmonology focusing on the novel use of established therapies such as mechanical ventilation and high frequency oscillatory ventilation as well as newer frontiers in the management of pulmonary hypertension using cell-based therapies. The ever-receding threshold of viability has contributed to a change in pulmonary pathophysiology requiring alteration in ventilatory management and will continue to challenge families and clinicians internationally.

At the time of birth the newborn lungs are fluid-filled and this liquid needs to be cleared from the lungs to ensure adequate gas exchange after clamping the umbilical cord. For most preterm infants clearing lung fluid is challenging and they often need non-invasive respiratory support to achieve this goal. However, applying adequate non-invasive support to preterm infants is technically difficult and sometimes ineffective because the larynx is closed. Spontaneous breathing may overcome some of these challenges. In this narrative review Dekker and colleagues describe interventions which focus on stimulation and maintenance of spontaneous breathing of preterm infants in the first few hours after birth.1

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Authors and Affiliations

  1. Department of Neonatology, Emma Children’s Hospital Amsterdam UMC, Amsterdam, The Netherlands

    Anton H. van Kaam

  2. Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands

    Anton H. van Kaam

  3. UH Rainbow Babies and Children’s Hospital, Cleveland, OH, USA

    Cynthia F. Bearer

  4. Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Cynthia F. Bearer

  5. Discipline of Paediatrics, Trinity College Dublin, the University of Dublin, Dublin, Ireland

    Eleanor J. Molloy

  6. Trinity Translational Medicine Institute (TTMI), St James Hospital & Trinity Research in Childhood Centre (TRiCC), Dublin, Ireland

    Eleanor J. Molloy

  7. Neonatology & Neurodisability, Children’s Health Ireland (CHI) at Crumlin & Tallaght, Dublin, Ireland

    Eleanor J. Molloy

  8. Paediatrics, Coombe Women’s and Infant’s University Hospital, Dublin, Ireland

    Eleanor J. Molloy

Authors
  1. Anton H. van Kaam
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  2. Cynthia F. Bearer
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  3. Eleanor J. Molloy
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Correspondence to Eleanor J. Molloy.

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van Kaam, A.H., Bearer, C.F. & Molloy, E.J. Neonatal pulmonology: optimizing transition and lung function in preterm infants. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03612-7

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  • DOI: https://doi.org/10.1038/s41390-024-03612-7

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