Pressure-Regulated Volume Control Ventilation vs Synchronized Intermittent Mandatory Ventilation for Very Low-Birth-Weight Infants

D’Angio, Carl T.; Chess, Patricia R.; Kovacs, Stephen J.; Sinkin, Robert A.; Phelps, Dale L.; Kendig, James W.; Myers, Gary J.; Reubens, Linda J.; Ryan, Rita M.

doi:10.1001/archpedi.159.9.868

Cited by 64 publications

(46 citation statements)

References 42 publications

(51 reference statements)

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“…Only three of these trials were primarily designed to compare the efficacy and safety of VG and conventional modes in RDS treatment [8,11,13]. The combined outcome of death or BPD was included in five trials [8,12,[14][15][16][17]. No individual trial reported a difference in the combined outcome of death or BPD, but the pooled meta-analysis revealed a reduction in this combined outcome (typical RR 0.73 [95 % CI 0.57-0.93], typical RD 0.12 [95 % CI 0.21-0.03], NNT 8 [95 % CI 5-33]).…”

Section: Discussionmentioning

confidence: 99%

Impact of volume guarantee on synchronized ventilation in preterm infants: a randomized controlled trial

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Impact of volume guarantee on synchronized ventilation in preterm infants: a randomized controlled trial

et al. 2012

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“…PTV was associated with a shorter duration of ventilation, but this was only seen in infants recovering from respiratory distress rather than in those in the acute stages. Similarly, in a recent randomised trial [9] in which infants were randomised at less than 6 h of age, pressure-regulated volume control ventilation (a synchronised, pressure limited A/C mode that sequentially varies the delivered pressure to approximate a target inspiratory tidal volume) compared to SIMV was not associated with an increased number of babies being extubated at 14 days. Newer modes of triggered ventilation have now been introduced.…”

Section: Patient-triggered Ventilation (Ptv)mentioning

confidence: 91%

What is new in ventilation strategies for the neonate?

Greenough

Sharma

2007

Eur J Pediatr

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A large number of ventilation strategies are now available for the neonate. This review has focused on new information, that is, studies published since 2000 and the implication of their results for current clinical practice. Meta-analysis of randomised trials has demonstrated that assist control and synchronous intermittent mandatory ventilation (SIMV) shortens the duration of ventilation only if started in the recovery rather than the early stage of respiratory disease. A recent randomised trial demonstrated pressure-regulated volume control ventilation may also have no advantages if started early. Weaning by SIMV with pressure support is better (reducing oxygen dependency) than SIMV alone. Meta-analysis of volume-targeted ventilation demonstrated significant reductions in the duration of ventilation and pneumothorax, but the trials were small and of different designs. Volume guarantee may provide more consistent blood gas control. The level of volume targeting appears to be crucial to the success of this technique. Meta-analysis of randomised trials of prophylactic high-frequency oscillation trials has shown a modest reduction in bronchopulmonary dysplasia. Randomised trials have failed to confirm the advantages of nasal continuous positive airway pressure (NCPAP) seen in various non-randomised studies; however, the randomised trials reported to date have been small. Inhaled nitric oxide (NO) does not improve the outcome of prematurely born infants with severe respiratory failure, but early low-dose prolonged iNO appears to have benefits that merit further testing. More randomised trials with long-term outcomes are required to identify the optimal ventilation strategy(ies) for the neonate.

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“…Volume-targeted ventilation has been shown to be effective in accelerating weaning in premature infants [12,22,26,27] . Although this faster weaning and shorter course of ventilation has not consistently improved long-term respiratory outcome, a meta-analysis showed improvements in the combined outcome of death or bronchopulmonary dysplasia (BPD) as indicated by a reduction in the relative risk of 0.73 (0.57 -0.93) compared with pressure-limited ventilation [31] .…”

Section: Automatic Adjustment Of Peak Pressure With Tidal Volume As Tmentioning

confidence: 99%

Role of automation in neonatal respiratory support

Claure

Bancalari²

2012

Journal of Perinatal Medicine

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Premature infants frequently present with respiratory instability, which is associated with fl uctuations in ventilation and gas exchange. Adjustment of respiratory support to the infant ' s needs is limited by staff availability and workload. Hence, automation is being explored as a way to improve the care of the premature infants. New modes of automatic respiratory support are being developed and becoming available for clinical use in preterm infants. These modes are expected to compensate for some of the limitations that presently exist in the conventional forms of respiratory support. Available evidence and preliminary fi ndings are promising, but further investigation is needed to determine the effects of these modalities on the long-term outcome of preterm infants.

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Pressure-Regulated Volume Control Ventilation vs Synchronized Intermittent Mandatory Ventilation for Very Low-Birth-Weight Infants

Abstract: In mechanically ventilated infants with birth weights of 500 to 1249 g, using PRVC ventilation from birth did not alter time to extubation.

Cited by 64 publications

References 42 publications

Impact of volume guarantee on synchronized ventilation in preterm infants: a randomized controlled trial

Impact of volume guarantee on synchronized ventilation in preterm infants: a randomized controlled trial

What is new in ventilation strategies for the neonate?

Role of automation in neonatal respiratory support

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