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Important breakthroughs in neonatology, particularly in prevention and treatment of respiratory disorders, have extended the limits of viability to lower gestational ages. Despite these advances, conventional mechanical ventilation (CMV)(usually pressure-limited intermittent mandatory ventilation in neonates)remains an essential therapy in neonatal intensive care. Advances in CMV, exogenous surfactant supplementation, and antenatal steroids have resulted in improved outcomes of critically ill neonates. Despite newer alternative ventilatory modes,such as high-frequency ventilation and patient-initiated mechanical ventilation, CMV continues to be the mainstay in the care of neonates.

Improved survival due to advances in neonatal care has resulted in an increased number of infants who are at risk for chronic lung disease and air leaks. Although the etiology of lung injury is multifactorial, recent animal and clinical data indicate that lung injury is largely dependent on the ventilatory strategies used. Optimal ventilatory strategies may improve the...

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