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Assisted ventilation is crucial to supporting very pre-term babies, but the treatment often leads to chronic lung disease. While survival of pre-term babies has increased over the past 30 years, rates of chronic lung disease have remained static. Researchers from the Murdoch Children’s Research Institute have found that the type of injury caused by ventilation depends on the gestational age of the lungs. The findings, published in Scientific Reports, suggest that individualised respiratory support could reduce risks to infants. In a study undertaken in lambs, the investigators mapped protein changes in blood plasma following ventilation of lambs born at term, pre-term (less than 32 weeks), and very pre-term (less than 26 weeks). By examining blood samples taken during the first 60 minutes of life, the researchers found significant changes in coagulant and complement protein expression in the pre-term lambs. The researchers noted that these changes indicated the potential for progressive lung injury, and would inhibit the effectiveness of some treatments options, such as surfactant administration. In the study’s next phase, the investigators will examine the changes in the lungs of pre-term human infants.