Effects of Pressure Support during an Acute Reduction of Synchronized Intermittent Mandatory Ventilation in Preterm Infants

Abstract

Assistance of the spontaneous breaths with pressure support maintained gas exchange. PS of 6 cm H(2)O prevented an increase in breathing effort during an acute 50% reduction in SIMV rate.

Mechanical Ventilation and Bronchopulmonary Dysplasia

“…To a significant degree, this problem may be overcome by adding pressure support ventilation (PS) to the spontaneous breaths during SIMV. 81 Although this approach is effective, it adds complexity and does not seem to have any advantage over A/C or PS used alone as long as atelectasis is avoided by using adequate level of PEEP. Additionally, it is important to recognize Ventilation and Bronchopulmonary Dysplasia that volume targeting is only applied to the SIMV inflations when using SIMV with PS and volume guarantee.…”

Setting the Ventilator in the NICU

“…To maintain adequate alveolar minute ventilation, relatively large V T is thus required with the limited number of mechanical infl ations provided by the ventilator. In a group of ELBW infants in the recovery phase of respiratory distress syndrome (RDS) ventilated with SIMV, the V T of mechanical infl ations was about 6 mL/kg with spontaneous V T of 2.5 mL/kg, very close to anatomical dead space (Osorio et al 2005 ). However, most clinicians continue to use SIMV, particularly during the weaning phase (Sharma and Greenough 2007 ).…”

Mechanical Ventilation

“…Although PSV is relatively new to the neonatal intensive care unit, there are multiple studies which have examined its mechanisms and clinical role in weaning newborns from mechanical ventilation Osorio et al 2005;Reyes et al 2006, Sarkar and Donn 2007, Gupta et al 2009). …”