Volume-targeted ventilation in infants born at or near term.
Arch Dis Child Fetal Neonatal Ed
; 97(4): F264-6, 2012 Jul.
Article
em En
| MEDLINE
| ID: mdl-22194469
ABSTRACT
OBJECTIVES:
To determine the impact of different volume-targeted (VT) levels during volume-targeted ventilation (VTV) on the work of breathing (WOB) of infants born at or near term and to investigate whether a level of VT reduced the WOB below that experienced on respiratory support without VT.DESIGN:
Prospective crossover study. PATIENTS Sixteen infants, median gestational age of 38 (range 34-41) weeks, birth weight of 3.1 (range 1.5-4.1) kg and postnatal age of 5 (range 2-17) days were studied. The infants were receiving time-cycled, pressure-limited ventilation in a continuous mandatory or in a triggered mode.INTERVENTIONS:
The infants were studied first without VT (baseline) and then at VT levels of 4, 5 and 6 ml/kg delivered in a random order. After each VT level, the infants were returned to baseline. MAIN OUTCOMEMEASURE:
The WOB was assessed by measuring the transdiaphragmatic pressure-time product (PTPdi).RESULTS:
One infant became apnoeic at VT of 6 ml/kg. At a VT level of 4 ml/kg, four infants were making such vigorous respiratory efforts that no inflations were delivered. The median PTPdi was higher at a VT level of 4 ml/kg than at 5 ml/kg (p<0.01) or 6 ml/kg (p<0.001). Only at a VT level of 6 ml/kg was the median PTPdi lower than that at baseline (p<0.01).CONCLUSION:
Low VT levels (4 ml/kg) during VTV increase the WOB in ventilated infants born at term or near term. The results suggest that a VT level of 6 ml/kg could be used to reduce the WOB.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Respiração Artificial
/
Cuidado do Lactente
/
Doenças do Recém-Nascido
Tipo de estudo:
Clinical_trials
/
Evaluation_studies
/
Observational_studies
Limite:
Humans
/
Newborn
Idioma:
En
Revista:
Arch Dis Child Fetal Neonatal Ed
Ano de publicação:
2012
Tipo de documento:
Article