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The role of artificial ventilation, oxygen, and CPAP in the pathogenesis of lung damage in neonates: assessment by serial measurements of lung function.

Lung volume, airway resistance, and compliance have been measured in 19 infants, 18 of whom suffered from the respiratory distress syndrome (RDS) at birth, while the remaining infant was ventilated for persistent apnea and a pneumothorax. Prior to discharge from the neonatal unit, and after recovery from RDS, most infants were found to have essentially normal lung function. When retested between 4 and 11 months of age, every infant who had received artificial ventilation during the acute illness was found to have developed a raised airway resistance, whereas the remaining infants, who had been treated with continuous positive airway pressure and/or oxygen were all entirely normal. The implications of these results for the management of RDS are discussed.