Increased and more consistent tidal volumes during synchronized intermittent mandatory ventilation in newborn infants.

Bernstein, Graham; Heldt, Gregory P.; Mannino, Frank L.

doi:10.1164/ajrccm.150.5.7952573

Cited by 60 publications

(29 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Invasive synchronized MV, compared with a nonsynchronized technique, has many positive effects such as increasing tidal volume of mechanical inflations, improving gas exchange [17,18] and reducing work of breathing (WOB), fluctuations in arterial blood pressure [17], rate of pneumothorax [19] and need for sedatives. These benefits of noninvasive ventilation of preterm infants are not generally known.…”

Section: Physiological Effects Of Synchronization During Nasal Ventilmentioning

confidence: 99%

Synchronized Nasal Intermittent Positive Pressure Ventilation of the Newborn: Technical Issues and Clinical Results

et al. 2016

View full text Add to dashboard Cite

Although mechanical ventilation via an endotracheal tube has undoubtedly led to improvement in neonatal survival in the last 40 years, the prolonged use of this technique may predispose the infant to development of many possible complications including bronchopulmonary dysplasia. Avoiding mechanical ventilation is thought to be a critical goal, and different modes of noninvasive respiratory support beyond nasal continuous positive airway pressure, such as nasal intermittent positive pressure ventilation and synchronized nasal intermittent positive pressure ventilation, are also available and may reduce intubation rate. Several trials have demonstrated that the newer modes of noninvasive ventilation are more effective than nasal continuous positive airway pressure in reducing extubation failure and may also be more helpful as modes of primary support to treat respiratory distress syndrome after surfactant and for treatment of apnea of prematurity. With synchronized noninvasive ventilation, these benefits are more consistent, and different modes of synchronization have been reported. Although flow-triggering is the most common mode of synchronization, this technique is not reliable for noninvasive ventilation in neonates because it is affected by variable leaks at the mouth and nose. This review discusses the mechanisms of action, benefits and limitations of noninvasive ventilation, describes the different modes of synchronization and analyzes the technical characteristics, properties and clinical results of a flow-sensor expressly developed for synchronized noninvasive ventilation.

show abstract

Section: Physiological Effects Of Synchronization During Nasal Ventilmentioning

confidence: 99%

Synchronized Nasal Intermittent Positive Pressure Ventilation of the Newborn: Technical Issues and Clinical Results

et al. 2016

View full text Add to dashboard Cite

show abstract

“…[13][14][15][16] There have also been several small short-term clinical trials of PC-SIMV versus PC-IMV or PC-CMV versus PC-IMV. [13][14][15][16][17][18][19][20] Overall, in neonates, PC-CMV has shown less V T variability, shorter weaning time, lower WOB, and better blood gas values and vital signs than PC-SIMV, and lower WOB and shorter duration of weaning than PC-IMV. 15 A recent Cochrane meta-analysis 21 evaluated 14 RCTs and compared differences in outcomes with patient-triggered ventilation versus non-patient-triggered ventilation (eg, PC-IMV).…”

Section: Continuous Mandatory Ventilation and Synchronized Intermittementioning

confidence: 99%

Mechanical Ventilation of the Premature Neonate

Brown

DiBlasi

2011

Respir Care

View full text Add to dashboard Cite

“…During invasive mechanical ventilation, it is well known that S-NIMV increases the tidal volume of mechanical inflations and improves gas exchange compared to NIMV [8,12] ; it also reduces WOB, fluctuations in arterial BP [8] , the rate of pneumothorax [13] and the need for sedatives or paralytic agents. The effects of synchronization during noninvasive ventilation of preterm infants are not well established [14,15] .…”

Section: Discussionmentioning

confidence: 99%

Effects of Synchronization during Noninvasive Intermittent Mandatory Ventilation in Preterm Infants with Respiratory Distress Syndrome Immediately after Extubation

Huang¹,

Mendler²,

Waitz³

et al. 2015

Neonatology

View full text Add to dashboard Cite

Background: Noninvasive ventilation is increasingly used in very-low-birth-weight infants (VLBWI) to reduce complications that occur with invasive ventilation. However, the physiological effects of synchronization during noninvasive nasal intermittent mandatory ventilation (IMV) have not been tested in VLBWI immediately after extubation. Objective: We aimed to study the short-term effects of synchronized nasal IMV (S-NIMV) compared to nonsynchronized nasal IMV (NIMV) on breathing effort as measured by phasic esophageal pressure (Pe) deflection, spontaneous respiratory rate (RR), gas exchange, cerebral tissue oxygen saturation (StO₂) and intermittent episodes of bradycardia or hypoxemia in VLBWI recovering from respiratory distress syndrome (RDS). Methods: Fourteen VLBWI recovering from RDS were studied using a randomized cross-over design during both S-NIMV and NIMV (of 2 h each) immediately after extubation. Results: Phasic Pe deflection, spontaneous RR and transcutaneous PCO₂ decreased significantly while transcutaneous PO₂ and synchrony rate (defined as peak ventilator pressure delivered within the first half of spontaneous inspiration) increased significantly during S-NIMV compared to during NIMV. There was no difference in blood pressure, average arterial oxygen saturation (SpO₂), cerebral StO₂, fractional tissue oxygen extraction of the brain and severe bradycardia (defined as time with a heart rate <100 beats/min lasting ≥10 s) and in hypoxemic episodes (SpO₂ <80%) between the two modes. Conclusion: Synchronization during nasal ventilation immediately after extubation in VLBWI recovering from RDS improved gas exchange and decreased the respiratory effort, and it could therefore be considered to provide a more efficient respiratory support and synchrony.

show abstract

Increased and more consistent tidal volumes during synchronized intermittent mandatory ventilation in newborn infants.

Cited by 60 publications

References 14 publications

Synchronized Nasal Intermittent Positive Pressure Ventilation of the Newborn: Technical Issues and Clinical Results

Synchronized Nasal Intermittent Positive Pressure Ventilation of the Newborn: Technical Issues and Clinical Results

Mechanical Ventilation of the Premature Neonate

Effects of Synchronization during Noninvasive Intermittent Mandatory Ventilation in Preterm Infants with Respiratory Distress Syndrome Immediately after Extubation

Contact Info

Product

Resources

About