Abstract
The immature lungs of extremely preterm infants are susceptible to damage by a variety of mechanisms that are potentially modifiable by careful use of lung-protective ventilation strategies. Avoidance of mechanical ventilation (MV), optimal delivery room stabilization, and early use of noninvasive respiratory support are important elements in minimizing lung injury. When MV is needed, it should be employed with care and with attention to individual patient’s specific pathophysiology. Achieving optimal lung inflation is a key element in any lung-protective ventilation strategy, including both conventional and high-frequency ventilation. Volume-targeted ventilation maintains more stable tidal volume and minute ventilation, shortens the duration of MV, and is associated with a decrease in both lung and brain injury.