Article Text

PDF
The effect of two levels of pressure support ventilation on tidal volume delivery and minute ventilation in preterm infants
  1. S Gupta1,
  2. S K Sinha2,
  3. S M Donn3
  1. 1
    University Hospital of North Tees, Stockton-on-Tees, UK
  2. 2
    University of Durham, The James Cook University Hospital, Middlesbrough, UK
  3. 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
  1. 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

Abstract

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.

Statistics from Altmetric.com

Footnotes

  • Competing interests: None.

  • Patient consent: Written informed consent was obtained from each parent prior to study entry.

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.