Published online by Cambridge University Press: 05 April 2016
Recent animal and human studies have challenged some of the prevailing concepts regarding the major physiological changes that characterize the transition to life after birth. In this chapter we will explain in detail how the breathing effort initiates a pulmonary and hemodynamic cascade of events that is of vital importance for survival after birth. The role of cord clamping and its effects on the hemodynamic transition will be discussed. This chapter also covers the pathophysiology of preterm infants failing transition and the current strategies caregivers can use to support them. Finally, we describe how positive pressure ventilation (PPV) can cause not only lung injury, but can also adversely affect cardiovascular function and initiate a systemic inflammatory cascade that can injure the immature brain.
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