{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T12:34:17Z","timestamp":1792499657999,"version":"4.5.0"},"reference-count":42,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,3,17]],"date-time":"2024-03-17T00:00:00Z","timestamp":1710633600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objectives: Respiratory distress syndrome (RDS) frequently necessitates respiratory support. While non-invasive methods are typically the preferred approach, mechanical ventilation becomes necessary for patients with insufficient response. Our study aimed to compare two common respiratory support modes, volume-targeted mechanical ventilation and non-invasive ventilation continuous positive airway pressure (CPAP) and high-flow nasal cannula (HFNC), using electrical impedance tomography. Materials and Methods: Infants with very low birth weight and gestational ages of less than 32 weeks were eligible for inclusion in the study. All enrolled infants were beyond the transitional period (&gt;72 h of age). The infants were divided into two groups: infants receiving invasive respiratory support through an endotracheal tube and infants receiving non-invasive respiratory support. We used electrical impedance tomography to assess end-expiratory lung impedance (EELZ), DeltaZ, heterogeneity, and regional ventilation distribution. Patients were evaluated at 0, 30, and 60 min after assuming the supine position to examine potential time-related effects. Results: Our study initially enrolled 97 infants, and the final analysis included a cohort of 72 infants. Ventilated infants exhibited significantly larger EELZ compared to their non-invasive counterparts (p = 0.026). DeltaZ was also greater in the invasive respiratory support group (p &lt; 0.001). Heterogeneity was higher in the non-invasive group and did not change significantly over time. The non-invasive group demonstrated significantly greater ventilation in the dependent lung areas compared to intubated patients (p = 0.005). Regional distribution in the left lung was lower than in the right lung in both groups; however, this difference was significantly more pronounced in intubated patients (p &lt; 0.001). Conclusions: Our study revealed that volume-targeted mechanical ventilation results in higher EELZ and DeltaZ compared to spontaneously breathing infants receiving non-invasive respiratory support. However, lung heterogeneity was lower during mechanical ventilation. Our study also reaffirmed that spontaneous breathing promotes greater involvement of the dependent lung compared to mechanical ventilation.<\/jats:p>","DOI":"10.3390\/medicina60030494","type":"journal-article","created":{"date-parts":[[2024,3,18]],"date-time":"2024-03-18T06:58:39Z","timestamp":1710745119000},"page":"494","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Respiratory Support Effects over Time on Regional Lung Ventilation Assessed by Electrical Impedance Tomography in Premature Infants"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6135-0993","authenticated-orcid":false,"given":"Ernestas","family":"Virsilas","sequence":"first","affiliation":[{"name":"Clinic of Children\u2019s Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, LT-03101 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arunas","family":"Valiulis","sequence":"additional","affiliation":[{"name":"Clinic of Children\u2019s Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, LT-03101 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raimondas","family":"Kubilius","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Skaiste","family":"Peciuliene","sequence":"additional","affiliation":[{"name":"Clinic of Children\u2019s Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, LT-03101 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arunas","family":"Liubsys","sequence":"additional","affiliation":[{"name":"Clinic of Children\u2019s Diseases, Institute of Clinical Medicine, Vilnius University Faculty of Medicine, LT-03101 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1159\/000528914","article-title":"European Consensus Guidelines on the Management of Respiratory Distress Syndrome: 2022 Update","volume":"120","author":"Sweet","year":"2023","journal-title":"Neonatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1159\/000487987","article-title":"Respiratory Management of Extremely Preterm Infants: An International Survey","volume":"114","author":"Beltempo","year":"2018","journal-title":"Neonatology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1067\/mpd.2001.118201","article-title":"Lung injury in neonates: Causes, strategies for prevention, and long-term consequences","volume":"139","author":"Clark","year":"2001","journal-title":"J. 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BMC Anesthesiol., 19.","DOI":"10.1186\/s12871-019-0814-7"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/3\/494\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:15:01Z","timestamp":1760105701000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/3\/494"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,17]]},"references-count":42,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["medicina60030494"],"URL":"https:\/\/doi.org\/10.3390\/medicina60030494","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,17]]}}}