In obesity, low-to-negative values of transpulmonary pressure predict lung collapse and intratidal recruitment/derecruitment. A decremental positive end-expiratory pressure trial preceded by a recruitment maneuver reverses atelectasis, improves lung mechanics, distribution of ventilation and oxygenation, and does not increase pulmonary vascular resistance.

The ability of leak compensation to prevent asynchronous breathing varied widely between ventilators and lung mechanics. The PB980 and V500 were the only two ventilators to acclimate to all leak scenarios in invasive ventilation, and PB980 was the only ventilator to acclimate to all leak scenarios in NIV.

The PB980 and V500 were the only ventilators to acclimate to all leak scenarios and achieve targeted V. Further clinical investigation is needed to validate the use of leak compensation during neonatal volume-targeted ventilation.

The low-cost bubble CPAP device evaluated in this study is comparable to a bubble CPAP system used in developed settings. Extensive clinical trials, however, are necessary to confirm its effectiveness.

SummaryThe Bicore