Early volume targeted ventilation in preterm infants born at 22–25 weeks of gestational age
Author(s) -
Wallström Linda,
Sjöberg Amanda,
Sindelar Richard
Publication year - 2021
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.25271
Subject(s) - medicine , hypocapnia , bronchopulmonary dysplasia , gestational age , ventilation (architecture) , anesthesia , birth weight , pediatrics , incidence (geometry) , mechanical ventilation , hypercapnia , pregnancy , mechanical engineering , physics , optics , biology , acidosis , engineering , genetics
Abstract Background Early hypocapnia in preterm infants is associated with intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia (BPD). Volume targeted ventilation (VTV) has been shown to reduce hypocapnia in preterm infants. Less is known of VTV in infants born at <26 weeks gestational age (GA). Objectives Our aim was to investigate the short‐ and long‐term effects of early VTV as compared to pressure limited ventilation (PLV) in extremely preterm infants on the incidence of hypocapnia, days on ventilatory support, IVH, and BPD. Study Design A retrospective observational study of 104 infants born at 22–25 weeks GA (mean ± SD; 24 +0 ± 1 +1 GA; birth weight 619 ± 146 g), ventilated with either VTV ( n = 44) or PLV ( n = 60) on their first day of life. Ventilatory data and blood gases were collected at admission and every fourth hour during the first day of life, together with perinatal characteristics and outcomes. Results Peak inflation pressure (PIP) was lower in the VTV‐group than in the PLV‐group during the first 20 h of life ( p < .05), without any difference in respiratory rate or FiO 2 . Incidence of hypocapnia (PaCO 2 < 4.5 kPa) was lower with VTV than PLV during the first day of life (32% vs. 62%; p < .01). Infants in the VTV‐group were more frequently extubated at 24 h (30% vs. 13%; p < .05). IVH Grade ≥3, BPD, and time on mechanical ventilation did not differ between the groups. Conclusions VTV is safe to apply in infants born at <26 GA and was observed to result in a lower incidence of hypocapnia compared to infants ventilated by PLV, without any differences in outcomes.