REVIEW

New modes of mechanical ventilation in the preterm newborn: evidence of benefit

Nelson Claure, Eduardo Bancalari

Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, USA

Eduardo Bancalari, PO Box 016960 R-131, Miami, FL 33101, USA; EBancalari@miami.edu

Accepted 12 June 2007

Abbreviations: A/C, assist/control ventilation; BPD, bronchopulmonary dysplasia; CMV, conventional mechanical ventilation; CTGI, continuous tracheal gas insufflation; ET, endotracheal tube; IMV, intermittent mandatory ventilation; IVH, intraventricular haemorrhage; MMV, mandatory minute ventilation; N-A/C, nasal A/C; NCPAP, nasal continuous positive airway pressure; N-SIMV, nasal SIMV; PAV, proportional assist ventilation; PIP, automated peak inspiratory pressure; PRVC, pressure-regulated volume-controlled; PSV, pressure support ventilation; PTV, patient triggered ventilation; RDS, respiratory distress syndrome; SIMV, synchronised intermittent mandatory ventilation; SIPPV, synchronised IPPV; TCPL, time-cycled pressure limited; VAPS, volume-assured pressure-support; VC, volume controlled ventilator; VG, volume guarantee ventilator; V_T, tidal volume

The first 150 words of the full text of this article appear below.

The introduction of modern mechanical ventilation in neonatal medicine in the 1960s was followed shortly thereafter by its use in premature infants with hyaline membrane disease. Most premature infants born before 30 weeks’ gestation receive some form of respiratory support, particularly those with fewer weeks of gestation.¹ Although mechanical ventilation is frequently a life-saving therapy, its use increases the risk of lung injury, particularly in preterm infants in whom the incidence of bronchopulmonary dysplasia (BPD) remains high.²

Before the current generation of neonatal ventilators, conventional mechanical ventilation (CMV) was provided mainly with time-cycled pressure limited (TCPL) ventilators developed from adaptation of Ayre’s T piece.³ This method, also known as intermittent mandatory ventilation (IMV), was and probably still is in many centres, the most common mode of ventilation.

During IMV mechanical breaths of fixed duration are delivered at predetermined time intervals. This frequently leads to asynchrony depending on the phase of . . . [Full text of this article]

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This article has been cited by other articles:

• Bhandari, A., Bhandari, V. (2009). Pitfalls, Problems, and Progress in Bronchopulmonary Dysplasia. Pediatrics 123: 1562-1573 [Abstract] [Full Text]