2 , 3 There is an increasing trend in the NICUs to use non-invasive ventilation modes; however, invasive ventilation is still often necessary for treating preterm and term infants with respiratory insufficiency. 4 , 5 The pharmacological agents administered by the respiratory route, in aerosol (a suspension of fine solid or liquid particles in gas dispensed from a pressurized container) or by nebulization (reduction of a medicinal solution to a fine spray) are often used during and after mechanical ventilation in order to improve pulmonary mechanics and facilitate ventilation.
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The ideal dosing remains unclear, but in 1 study, there was a significant improvement in the oxygenation index at 30 ng/kg/min, and a trend toward significance at doses of 20, 40, and 50 ng/kg/min (LoE B). 68 , 69 Iloprost It is a prostacyclin analog pharmacologically similar to epoprostenol, with a longer half-life (20-30 minutes), lower viscosity, greater stability, and more physiologic pH, turning it a better choice for nebulization.