接近生存能力的早产儿通常需要机械通气（MV）来治疗呼吸窘迫综合征。尽管常用的肺保留通气技术，但 MV 期间肺的快速扩张会导致肺损伤，这是支气管肺发育不良的危险因素。本研究探讨优化肺扩张的通气是否可行，以及是否可以进一步减少肺损伤。因此，将优化肺扩张通气 (OLEV) 与常规容量目标通气进行比较。 20 只早产羔羊在妊娠 132 天后通过手术分娩。九只动物被随机接受 OLEV 24 小时，七只动物接受标准 MV。四只不通气的动物作为对照（NV）。实验结束时对肺部取样进行组织学分析。OLEV 通气是可行的，导致平均通气压力显着升高（0.7-1.3 mbar）。 OLEV 和 MV 之间的暂时氧合差异未达到临床相关水平。一般来说，与 NV 相比，通气往往会导致更高的肺损伤评分，但 OLEV 和 MV 之间没有差异。虽然与 NV 相比，两个通气组的促炎性肿瘤坏死因子-α 信使 RNA (mRNA) 水平均有所增加，但只有 MV 组的动物肺部显示出较高数量的 CD45 阳性细胞。相反，与 NV 1.03 (0.32) 相比，OLEV 中表面活性剂蛋白 B mRNA 的平均值（标准差）显着降低，为 0.63 (0.38)（p = .023，单向方差分析）。使用 OLEV 支持 24 小时后肺部炎症的减少表明有可能减少早产肺损伤。© 2024 作者。小儿肺病学由 Wiley periodicals LLC 出版。

Preterm infants close to viability commonly require mechanical ventilation (MV) for respiratory distress syndrome. Despite commonly used lung-sparing ventilation techniques, rapid lung expansion during MV induces lung injury, a risk factor for bronchopulmonary dysplasia. This study investigates whether ventilation with optimized lung expansion is feasible and whether it can further minimize lung injury. Therefore, optimized lung expansion ventilation (OLEV) was compared to conventional volume targeted ventilation.Twenty preterm lambs were surgically delivered after 132 days of gestation. Nine animals were randomized to receive OLEV for 24 h, and seven received standard MV. Four unventilated animals served as controls (NV). Lungs were sampled for histological analysis at the end of the experimental period.Ventilation with OLEV was feasible, resulting in a significantly higher mean ventilation pressure (0.7-1.3 mbar). Temporary differences in oxygenation between OLEV and MV did not reach clinically relevant levels. Ventilation in general tended to result in higher lung injury scores compared to NV, without differences between OLEV and MV. While pro-inflammatory tumor necrosis factor-α messenger RNA (mRNA) levels increased in both ventilation groups compared to NV, only animals in the MV group showed a higher number of CD45-positive cells in the lung. In contrast, mean (standard deviations) surfactant protein-B mRNA levels were significantly lower in OLEV, 0.63 (0.38) compared to NV 1.03 (0.32) (p = .023, one-way analysis of variance).In conclusion, a small reduction in pulmonary inflammation after 24 h of support with OLEV suggests potential to reduce preterm lung injury.© 2024 The Author(s). Pediatric Pulmonology published by Wiley Periodicals LLC.