Randomised study comparing extent of hypocarbia in preterm infants during conventional and patient triggered ventilation
K Luyta, D Wrightb, J H Baumera
a Child Health
Department, Derriford Hospital, Derriford Road, Plymouth PL6 8DH,
Devon, UK, b Department of Mathematics and Statistics,
University of Plymouth, Plymouth PL4 8AA, Devon, UK
Correspondence to: Dr Luyt kluyt{at}doctors.org.uk
Accepted 18 July 2000
AIM
To determine whether patient
triggered ventilation (PTV) leads to greater exposure to significant
hypocarbia than conventional ventilation (CMV) in premature infants
during the first 72 hours of life.
METHODSInfants of 32 weeks
gestation or less were included. Randomisation yielded 74 infants on
PTV and 68 infants on CMV. Arterial PaCO2
measurements were taken four hourly for the first 72 hours of life.
RESULTSThe mean
PaCO2 levels on days 1, 2, and 3 were not
significantly different between the two groups. The proportion of
infants with PaCO2 levels of 3.33 kPa or less
did not differ between PTV and CMV infants. Mean percentages of infants
with this level of hypocarbia at any time were 31.4%, 18.9%, 8.8% on
days 1, 2, and 3 respectively. Cumulative hypocarbia, below a 3.33 kPa
threshold, was 0.0084 kPa.h (PTV) versus 0.0263 kPa.h (CMV) per hour
ventilated during the first 24 hours (p = 0.259). Risk factors
associated with hypocarbia on day 1 were peak inspiratory pressure
below 14 cm H2O (odds ratio 4.79) as well as
FiO2 below 0.30 (odds ratio 3.42).
CONCLUSIONExposure to hypocarbia
(PaCO2 3.33 kPa or below) was not significantly
different between PTV and CMV infants during the first 72 hours of
life. Hypocarbia was common in both groups on day 1 and to a lesser
extent on day 2. Infants with the least requirements for ventilatory
support were at highest risk of hypocarbia on day 1 of life. Preterm
infants with mild hyaline membrane disease require a more aggressive
approach to weaning on both modes of ventilation, followed by
extubation to limit the risk of hypocarbia.
Keywords: patient triggered ventilation; intermittent positive pressure ventilation; hypocarbia
© 2001 by Archives of Disease in Childhood
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Grover, A, Field, D
(2008). Volume-targeted ventilation in the neonate: time to change?. Arch. Dis. Child. Fetal Neonatal Ed.
93: F7-F13
[Full Text] -
D'Angio, C. T., Chess, P. R., Kovacs, S. J., Sinkin, R. A., Phelps, D. L., Kendig, J. W., Myers, G. J., Reubens, L., Ryan, R. M.
(2005). Pressure-Regulated Volume Control Ventilation vs Synchronized Intermittent Mandatory Ventilation for Very Low-Birth-Weight Infants: A Randomized Controlled Trial. Arch Pediatr Adolesc Med
159: 868-875
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in ADC Online
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
