How to reduce invasiveness in non-invasive ventilation.

Non invasive ventilation plays a key role in neonatal intensive care unit (NICU) activity and several instruments have recently been developed that are designed to maintain positive pressure in order to improve functional residual capacity of the lung. However, devices used to provide non-invasive respiratory assistance are frequently a cause of discomfort when applied to a fragile neonate. Indeed, they are applied for lengthy periods in low birth weight (VLBW) infants. In addition to these side effects we have to consider several other stressful events. In our opinion, reducing invasiveness in the NICU is a process where the main steps are recognizing a need for the organization of diagnostic and therapeutic procedures with respect for the rhythm of the newborn, recognizing the fragility of preterm newborns and their brain plasticity, improving environmental standards in both structural terms and staff behaviour, and promoting the active role of parents in supporting the development of the newborn.