Archives of Disease in Childhood - Fetal and Neonatal Edition 2009;94:F80-F83
ORIGINAL ARTICLES
The effect of two levels of pressure support ventilation on tidal volume delivery and minute ventilation in preterm infants
1 University Hospital of North Tees, Stockton-on-Tees, UK
2 University of Durham, The James Cook University Hospital, Middlesbrough, UK
3 Division of Neonatal-Perinatal Medicine, C.S. Mott Children’s Hospital, University of Michigan Health System, Ann Arbor, Michigan, USA; Smdonnmd@med.umich.edu
Sunil K Sinha, Professor of Paediatrics, University of Durham, Consultant in Paediatrics and Neonatal Medicine, The James Cook University Hospital, Middlesbrough, UK; Sunil.sinha{at}stees.nhs.uk
Objective: To study the effect of different levels of pressure support ventilation (PSV) on respiratory parameters in preterm infants during the weaning phase of mechanical ventilation.
Design/methods: In this quasi-experimental crossover study, a total of 19 154 breaths were analysed from 10 ventilated infants of <32 weeks’ gestation. Breath-to-breath data on minute ventilation, tidal volume, respiratory rate, peak inspiratory pressure and mean airway pressure were collected during three study epochs: synchronised intermittent mandatory ventilation (SIMV) alone, SIMV with partial PSV (PSmin), and SIMV with full PSV (PSmax). PSmin was set to provide an exhaled tidal volume (VTe) between 2.5–4 ml/kg and PSmax 5–8 ml/kg VTe. Statistical analyses were performed using analysis of variance (ANOVA) for repeated measures.
Results: The addition of full PSV (PSmax) was associated with a significant increase in total minute ventilation as compared with SIMV alone (392 ml/kg/min vs 270 ml/kg/min, respectively; p<0.05). This difference in minute ventilation was still present when PSmin was used (332 ml/kg/min as compared with 270 ml/kg/min in SIMV; p<0.05). There was also a concomitant decrease in the respiratory rate with both PSmax (59 breaths per minute) and PSmin (65 breaths per minute) compared with SIMV alone (72 breaths per min) (p<0.05).
Conclusions: Pressure support ventilation increases total minute ventilation and stabilises breathing in proportion to the level of pressure support used. This may be advantageous and provide a useful ventilation strategy for use during weaning stages of mechanical ventilation in preterm infants.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
-
All Versions of this Article:
adc.2007.123679v1
94/2/F80 most recent - Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
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.
