Abstract:
OBJECTIVES:The objectives of this study were to determine the impact of different volume-targeted levels on the work of breathing and to investigate whether a level that reduced the work of breathing below that experienced during ventilatory support without volume targeting could be determined. METHODS:The transdiaphragmatic pressure-time product, as an estimate of the work of breathing, was measured for 20 infants (median gestational age: 28 weeks) who were being weaned from respiratory support by using patient-triggered ventilation (either assist-control ventilation or synchronous intermittent mandatory ventilation). The transdiaphragmatic pressure-time product was measured first without volume targeting (baseline) and then at volume-targeted levels of 4, 5, and 6 mL/kg, delivered in random order. After each volume-targeted level, the infants were returned to baseline. Each step was maintained for 20 minutes. RESULTS:The mean transdiaphragmatic pressure-time product was higher with volume targeting at 4 mL/kg in comparison with baseline, regardless of the patient-triggered mode. The transdiaphragmatic pressure-time product was higher at a volume-targeted level of 4 mL/kg in comparison with 5 mL/kg and at 5 mL/kg in comparison with 6 mL/kg. The mean work of breathing was below that at baseline only at a volume-targeted level of 6 mL/kg. CONCLUSIONS:Low volume-targeted levels increase the work of breathing during volume-targeted ventilation. Our results suggest that, during weaning, a volume-targeted level of 6 mL/kg, rather than a lower level, could be used to avoid an increase in the work of breathing.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Patel DS,Sharma A,Prendergast M,Rafferty GF,Greenough Adoi
10.1542/peds.2008-2635subject
Has Abstractpub_date
2009-04-01 00:00:00pages
e679-84issue
4eissn
0031-4005issn
1098-4275pii
peds.2008-2635journal_volume
123pub_type
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