Mechanical ventilation of very low birth weight infants: Is volume or pressure a better target variable?

Singh, Jaideep, Sinha, Sunil K., Clarke, Paul, Byrne, Steve and Donn, Steven M. (2006) Mechanical ventilation of very low birth weight infants: Is volume or pressure a better target variable? Journal of Pediatrics, 149 (3). pp. 308-313. ISSN 0022-3476

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Abstract

OBJECTIVE: To compare the efficacy and safety of volume-controlled (VC) ventilation to time-cycled pressure-limited (TCPL) ventilation in very low birth weight infants with respiratory distress syndrome (RDS). STUDY DESIGN: Newborns weighing between 600 and 1500 g and with a gestational age of 24 to 31 weeks who had RDS were randomized to receive either VC or TCPL ventilation and treated with a standardized protocol. The 2 modalities were compared by determining the time required to achieve a predetermined success criterion, on the basis of either the alveolar-arterial oxygen gradient <100 mm Hg or the mean airway pressure <8 cm H(2)O. Secondary outcomes included mortality, duration of mechanical ventilation, and complications commonly associated with ventilation. RESULTS: The mean time to reach the success criterion was 23 hours in the VC group versus 33 hours in the TCPL group (P = .15). This difference was more striking in babies weighing <1000g (21 versus 58 hours; P = .03). Mean duration of ventilation with VC was 255 hours versus 327 hours with TCPL (P = .60). There were 5 deaths in the VC group and 10 deaths in the TCPL group (P = .10). The incidence of other complications was similar. CONCLUSION: VC ventilation is safe and efficacious in very low birth weight infants and may have advantages when compared with TCPL, especially in smaller infants.

Item Type: Article
Uncontrolled Keywords: female,humans,infant, newborn,infant, premature,infant, very low birth weight,lung volume measurements,male,physiology,methods,mortality,survival rate,treatment outcome
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 28 Oct 2020 01:14
Last Modified: 24 Nov 2020 01:46
URI: https://ueaeprints.uea.ac.uk/id/eprint/77448
DOI: 10.1016/j.jpeds.2006.01.044

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