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

A peak inspiratory pressure of 35 cmH2O in neonatal ventilation is particularly associated with barotrauma as it indicates elevated intrathoracic pressures during mechanical ventilation. Barotrauma occurs when excessive pressure leads to damage in the lungs, especially in preterm infants whose alveoli and lung structures are fragile and underdeveloped. When the pressures are too high, it can cause rupture of the alveoli, leading to air leaks into the surrounding tissues and potentially causing pneumothorax or other complications.

While retinopathy of prematurity and pulmonary air leaks are significant concerns in neonates, they are not directly indicated to be caused solely by elevated peak inspiratory pressures like barotrauma is. Therefore, while all these conditions may be present in the context of neonatal care, the specific risk associated with a peak inspiratory pressure of 35 cmH2O is primarily linked to barotrauma, which makes this the focus of concern in this scenario.