A peak inspiratory pressure of 35 cmH2O in neonatal ventilation increases the risk of which complications?

In the context of neonatal ventilation, a peak inspiratory pressure (PIP) of 35 cmH2O is considered relatively high and is often associated with increased risk for several complications. In particular, barotrauma is a significant risk factor since excessive pressure during ventilation can cause damage to the lung tissue, leading to ruptures in alveoli or air leaks into the pleural space.

Barotrauma occurs when the pressure of the gas being delivered exceeds the tolerance of the lung's structures. With neonates, whose lung tissue is often more fragile due to conditions like surfactant deficiency or immature lung development, high PIP levels can lead to complications such as pneumothorax (air outside the lung) or pulmonary interstitial emphysema, where air escapes into the lung parenchyma.

While retinopathy of prematurity and pulmonary air leaks are relevant conditions in the context of neonatal care, they are not directly caused by high peak inspiratory pressures. Retinopathy of prematurity is primarily linked to high oxygen levels and fluctuations in oxygenation, and pulmonary air leaks can arise from various factors but are not solely attributable to PIP levels.

Thus, among the options given, focusing on the implications of increased peak inspiratory pressure