Assisted Ventilation in Newborns: Less May Be More!
For many of us who trained in the 1980s, it was an exciting time to be in neonatology, particularly for clinicians with a special interest in respiratory medicine. Surfactant was just around the corner1; newer ventilators were being introduced, and high-frequency ventilation and extracorporeal membrane oxygenation had gained traction as rescue therapies, while liquid ventilation2 was ready to undergo human trials. These advances collectively contributed to a significant drop in mortality and growth of the subspecialty. Yet, unbeknownst to many, a culture was emerging in our neonatal intensive care units (NICUs) that would later prove to be harmful: we had begun to believe that early and more is better, and a preemptive aggressive approach to managing respiratory problems had taken off....