Scientists discover ventilation danger to preterm babies and offer solution

Preterm babies often cannot breathe on their own because their lungs aren't fully formed, so they need to be ventilated.

 Premature infants being cared for in incubators in the Special Care Baby Unit at Al-Shifa Hospital in Gaza City. (photo credit: HAZEM ALBAZ/THE MEDIA LINE)
Premature infants being cared for in incubators in the Special Care Baby Unit at Al-Shifa Hospital in Gaza City.
(photo credit: HAZEM ALBAZ/THE MEDIA LINE)

Researchers have discovered that ventilators for preterm babies can be damaging to them and have proposed the use of an anti-inflammatory drug to prevent it.

While in the womb, the fetus receives oxygen through the umbilical cord, but when babies are born too early, as is the case in one in 10 babies, their lungs are not fully formed and they cannot breathe properly on their own. The earlier the baby is born, the harder it is for them to breathe.

The study, which was published in the peer-reviewed Bioengineering and Translational Medicine journal, was led by Professor Josué Sznitman from the Technion Faculty of Biomedical Engineering and discovered that the force of the air jet in the ventilators used for preterm babies causes the baby's cells to stress, leading to inflammation. 

The scientists tested the use of an anti-inflammatory drug that is commonly used for asthma patients and found that it succeeded in preventing the damage that is usually caused by the ventilator.

In high-income countries, most preterm babies survive, but they suffer from varied life-long disabilities. One of the big problems is that while the babies need ventilators to keep them alive, they can also cause adverse side effects.

 Doctors check a premature infant in the Special Care Baby Unit at Al-Shifa Hospital in Gaza City. (credit: HAZEM ALBAZ/THE MEDIA LINE) Doctors check a premature infant in the Special Care Baby Unit at Al-Shifa Hospital in Gaza City. (credit: HAZEM ALBAZ/THE MEDIA LINE)

Sznitman and his then-doctoral student, Dr. Eliram Nof, discovered the issue caused by ventilators and published it in the peer-reviewed Journal of the Royal Society Interface. They then published the proof in a study they conducted in the peer-reviewed Bioengineering & Translational Medicine journal.

"Today, we know that artificial ventilation incurs various trauma to the respiratory system despite being an established, life-saving procedure," said Sznitman. "Much of this damage has been attributed to mechanical factors such as high pressure and distention of deep lung tissue. 

"In recent years, new insights into more complex processes have emerged. In the current study, we demonstrated in vitro the start of an inflammatory response at the core of morbidity in invasively ventilated infants. We linked the flow-induced shear stresses to inflammation by measuring cytokines, the messengers of the immune system, and tracking epithelial cell health."

These discoveries can be helpful beyond preterm babies. The issues caused by the ventilators have been observed in adults too and more so during COVID-19 when people needed to be put on ventilators long-term. These patients were found to be more likely to die. These discoveries can help save their lives even if they need a ventilator.