| dc.description.abstract | Newborns have a greater predisposition to suffer
from pulmonary atelectasis due to their anatomical
and physiological characteristics. Examples of these
are decreased caliber of the airways, less consistent
anatomical repairs, fewer collateral ventilation
channels, zero transpulmonary pressure at the end of
expiration and a weak chest wall compared to the adult.
Preterm newborns deserve special mention due to the
immaturity of the lung tissues, decreased compliance,
and quality and quantity of endogenous surfactant,
related to gestational age.
The trend in neonatal intensive care units (NICU) is to
avoid or reduce the days of invasive ventilation and
oxygen administration to prevent bronchopulmonary
dysplasia (BPD) and retinopathy of prematurity (ROP),
among other aspects. There are clinical events in which
the need to place an endotracheal tube (ETT) and the
use of mechanical ventilatory assistance (MVA) are
transformed into essential therapeutic requirements
for the recovery of the newborn.
The days of stay in MVA bring with them alterations
in the protective mechanisms of the respiratory tract;
By decreasing ciliary activity and increasing mucus
production, an inflammatory response is generated
with edema and necrosis of the respiratory epithelium.
These factors affect the difficulty of mobilization of
secretions outside the tracheobronchial area, with
increased resistance of the respiratory tract and
production of atelectasis.
There are some treatments that are promising, but
their efficacy and safety in neonates has not yet been
demonstrated; such is the case of recombinant human
deoxyribonuclease inhalation with demonstrated
efectiveness in atelectasis for pediatric patients.
Currently the care that has evidence regarding the
prevention or improvement of obstructions and
atelectasis are the conditions for the administration
of the gas mixture, the postural drainage and the
selection of the ventilatory modality. | en_US |
