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Impact of targeted‐volume ventilation on pulmonary dynamics in preterm infants with respiratory distress syndrome
Author(s) -
Alkan Ozdemir Senem,
Arun Ozer Esra,
Ilhan Ozkan,
Sutcuoglu Sumer
Publication year - 2017
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23510
Subject(s) - medicine , respiratory distress , intermittent mandatory ventilation , ventilation (architecture) , mechanical ventilation , gestational age , anesthesia , respiratory failure , atelectasis , peak inspiratory pressure , respiratory minute volume , neonatal respiratory distress syndrome , tidal volume , respiratory system , pediatrics , pregnancy , lung , mechanical engineering , biology , engineering , genetics
Summary Background Mechanical ventilation is an essential therapy in the treatment of respiratory failure in preterm infants. However, optimal ventilation strategy continues to be difficult to define. Objective To compare the effects of volume guarantee (VG) combined with intermittent mandatory ventilation (SIMV) and VG combined with pressure support ventilation (PSV) on the pulmonary mechanics and short term prognosis in preterm infants with respiratory distress syndrome. Methods Infants of <32 weeks gestational age ventilated for respiratory distress syndrome were randomized to receive either SIMV + VG or PSV + VG. The patient characteristics, ventilator variables including PIP, PEEP, MAP, VT, dynamic compliance, resistance, C20/C, and neonatal outcomes (IVH, ROP, oxygen dependency at 28th postnatal day and 36 weeks of PMA), mortality and extubation failure were recorded in each groups. Results Thirty‐four infants were enrolled in to the study: 19 patients were randomized to the SIMV + VG group, and 15 patients to the PSV + VG group. No significant differences were observed between the two groups in terms of the birth weight, gestational age, gender, multiple pregnancy, delivery mode, and antenatal steroid treatment. The respiratory and ventilatory parameters were similar in the groups. The need for reintubation were common in SIMV + VG group ( P < 0.01). Conclusions Volume guaranteed ventilation combined with PSV may be a convenient method for preterm infants with RDS in terms of reducing postextubation atelectasis and the need for reintubation. Pediatr Pulmonol. 2017;52:213–216. © 2016 Wiley Periodicals, Inc.