Respiratory Care of Infants Born at the Limits of Viability

Amy A. Hobson; Brady J. Thomas; Jonathan M. Klein; Tarah T. Colaizy

doi:10.1016/j.clp.2026.02.001

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Respiratory Care of Infants Born at the Limits of Viability

Journal article

Peer reviewed

Respiratory Care of Infants Born at the Limits of Viability

Amy A. Hobson, Brady J. Thomas, Jonathan M. Klein and Tarah T. Colaizy

Clinics in perinatology

04/2026

DOI: 10.1016/j.clp.2026.02.001

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Abstract

The authors present the University of Iowa’s approach to respiratory management for infants born at 21 to 24 weeks’ gestation in 3 phases of care. In the acute phase, they address the challenges of supporting immature lungs in the canalicular stage by using early high-frequency jet ventilation to minimize volutrauma with careful avoidance of hyperinflation. In the subacute phase, ventilatory support continues until there are consistent signs of respiratory and developmental readiness for extubation, followed by the postextubation weaning phase of noninvasive support. This approach prioritizes lung protection and growth, and minimizes long-term morbidity in extremely low gestational age infants.

Bronchopulmonary dysplasia

High frequency jet ventilation

Periviable infants

Details

Title: Subtitle: Respiratory Care of Infants Born at the Limits of Viability
Creators: Amy A. Hobson - University of Iowa
Brady J. Thomas - University of Iowa
Jonathan M. Klein - University of Iowa
Tarah T. Colaizy - University of Iowa
Resource Type: Journal article
Publication Details: Clinics in perinatology
DOI: 10.1016/j.clp.2026.02.001
ISSN: 0095-5108
eISSN: 1557-9840
Publisher: Elsevier
Language: English
Electronic publication date: 04/2026
Academic Unit: Stead Family Department of Pediatrics; Neonatology
Record Identifier: 9985153399902771

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