Which mode of ventilation is most appropriate for infants at risk of developing BPD?

The most appropriate mode of ventilation for infants at risk of developing Bronchopulmonary Dysplasia (BPD) is high-frequency oscillatory ventilation. This mode is beneficial in minimizing lung injury by delivering very small tidal volumes at a high frequency. The gentle and continuous pressure helps to maintain alveolar recruitment while reducing the barotrauma and volutrauma that can occur with conventional ventilation methods.

High-frequency oscillatory ventilation has been shown to improve gas exchange and reduce the need for higher oxygen concentrations, which are important factors in the prevention of BPD. Infants with developing lungs are particularly vulnerable to injury from mechanical ventilation; thus, maintaining a delicate balance between ventilation and lung protection is crucial.

In contrast, continuous positive airway pressure (CPAP) and non-invasive positive pressure ventilation may be useful for maintaining lung volume and preventing atelectasis, but they do not directly address the need for effective gas exchange in rapidly deteriorating respiratory conditions like severe respiratory distress. Conventional mechanical ventilation, while it can be helpful in some cases, poses a higher risk for lung injury and BPD due to the potential for over-distention and injury from larger tidal volumes or pressure settings.