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Paediatr Respir Rev. 2016 Jan;17:71-9. doi: 10.1016/j.prrv.2015.08.015. Epub 2015 Oct 22.

Ventilation strategies for preventing oxidative stress-induced injury in preterm infants with respiratory disease: an update.

Author information

1
Neonatal Intensive Care Unit, Children Hospital, Spedali Civili of Brescia, Brescia, Italy, PhD course in Intensive Care, University of Messina, Messina, Italy.
2
Department of Pediatrics, University of Messina, Messina, Italy. Electronic address: lmarseglia@unime.it.
3
Department of Pediatrics, University of Messina, Messina, Italy.
4
Department of Neurosciences, Psychiatric and Anesthesiological Sciences, University of Messina, Messina, Italy.
5
Neonatal Intensive Care Unit, Children Hospital, Spedali Civili of Brescia, Brescia, Italy.

Abstract

Reactive oxygen and nitrogen species are produced by several inflammatory and structural cells of the airways. The lungs of preterm newborns are susceptible to oxidative injury induced by both reactive oxygen and nitrogen species. Increased oxidative stress and imbalance in antioxidant enzymes may play a role in the pathogenesis of inflammatory pulmonary diseases. Preterm infants are frequently exposed to high oxygen concentrations, infections or inflammation; they have reduced antioxidant defense and high free iron levels which enhance toxic radical generation. Multiple ventilation strategies have been studied to reduce injury and improve outcomes in preterm infants. Using lung protective strategies, there is the need to reach a compromise between satisfaction of gas exchange and potential toxicities related to over-distension, derecruitment of lung units and high oxygen concentrations. In this review, the authors summarize scientific evidence concerning oxidative stress as it relates to resuscitation in the delivery room and to the strategies of ventilation.

KEYWORDS:

lung; oxidative stress; oxygen; preterm newborn; ventilation.

PMID:
26572937
DOI:
10.1016/j.prrv.2015.08.015
[Indexed for MEDLINE]

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