Ventilation/Oxygen
Reduction of volume and distending airway pressure will
help reduce volutrauma and minimize alterations in the
architecture of the developing airway. The use of positive
pressure, even CPAP, has an impact on the ability of the
neonate to continue to grow new saccules and alveoli,
even after birth. Maintaining functional residual capacity
and avoiding repeated bouts of atelectasis is an increasingly
common strategy. Oxygen, though essential to avoid
tissue damage and allow for anabolic growth, can also be
damaging in concentrations that are higher than necessary.
Studies have evaluated what is considered a “safe
range” for oxygen saturations and have recommended
the range of 90%–95%. However, it is more important to
avoid frequent swings in oxygen saturations from hypoxic
155 Baby Steps to Home Diagnoses
to hyperoxic states, because this affects overall growth
and neurodevelopmental outcomes.