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Patient-initiated, pressure-regulated, volume-controlled ventilation compared with intermittent mandatory ventilation in neonates: a prospective, randomised study.

Abstract：

OBJECTIVE:To compare the effects of patient-initiated, pressure-regulated, volume-controlled ventilation (PRVC) with pressure-preset intermittent mandatory ventilation (IMV) in neonates with respiratory failure. DESIGN:Randomised, prospective study. SETTING:Intensive care unit (14 beds) in a 300-bed paediatric teaching hospital. PATIENTS:60 neonates with respiratory distress syndrome (RDS) or congenital pneumonia, weighing < 2500 g and requiring mechanical ventilation. INTERVENTIONS:Ventilatory support until extubation via either IMV (n = 30) or PRVC (n = 27). In PRVC, the tidal volume (VT) was preset and pressure-controlled breaths delivered with peak inspiratory pressure values adapted to achieve the preset VT. MEASUREMENTS AND RESULTS:Main outcome measures were duration of ventilation and incidence of bronchopulmonary dysplasia (BPD). Pulmonary air leaks and intraventricular haemorrhage (IVH) were considered major adverse effects. Demographic data, ventilation parameters and arterial/alveolar oxygen tension ratio were similar at randomisation. Duration of ventilation and incidence of BPD were not decreased by the use of PRVC. Air leaks occurred in 3 neonates in the PRVC group and in 7 babies treated with IMV (NS). The incidence of IVH grade > II was lower in babies treated with PRVC (p < 0.05). In a subgroup of neonates weighing < 1000 g, the duration of ventilation and incidence of hypotension were reduced in the PRVC group (p < 0.05). CONCLUSION:Patient-initiated, pressure-regulated, volume-controlled ventilation can be safely used in neonates and may contribute to a lower incidence of complications.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Piotrowski A,Sobala W,Kawczyński P

doi

10.1007/s001340050441

subject

Has Abstract

pub_date

1997-09-01 00:00:00

pages

975-81

issue

9

eissn

0342-4642

issn

1432-1238

journal_volume

23

pub_type

临床试验,杂志文章,随机对照试验

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