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An international survey of volume-targeted neonatal ventilation
  1. Claus Klingenberg1,2,3,
  2. Kevin I Wheeler1,4,5,
  3. Louise S Owen1,4,
  4. Per I Kaaresen2,3,
  5. Peter G Davis1,4,6
  1. 1Newborn Services, Royal Women's Hospital, Melbourne, Australia
  2. 2Department of Paediatrics, University Hospital of North Norway, Tromsø, Norway
  3. 3Department of Paediatrics, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway
  4. 4Murdoch Children Research Institute, Melbourne, Australia
  5. 5Department of Physiology, Monash University, Melbourne, Australia
  6. 6Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
  1. Correspondence to Claus Klingenberg, Neonatal Services/Department of Newborn Research, Royal Women's Hospital, 20 Flemington Road, Parkville, Melbourne, Victoria 3052, Australia; claus.klingenberg{at}unn.no

Abstract

Objective To evaluate clinical practice of volume-targeted ventilation (VTV).

Design Internet-based survey of all 50 tertiary neonatal units in Australia, New Zealand, Sweden, Denmark, Finland and Norway.

Results Response rate was 100%. VTV was routinely used in 25 (50%) units; 15/25 (60%) in Australasia and 10/25 (40%) in the Nordic countries. The most common reason given for using VTV was that it reduces bronchopulmonary dysplasia (13/25; 52%). The median (IQR) of upper limits of target tidal volume were (1) for initial ventilation of preterm infants with respiratory distress syndrome 5.0 (4.6–6.0) ml/kg and (2) for infants with ventilator-dependent bronchopulmonary dysplasia 6.0 (5.0–8.0) ml/kg. The median (IQR) maximum peak inspiratory pressure limit units were prepared to use in VTV-mode was 35 (30–42.5) cm H2O.

Conclusion Half of the units used VTV routinely, but with a considerable variation in VTV practice. More studies are required to establish best VTV practice.

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Footnotes

  • In Australia The Townsville Hospital, Townsville; Mater Mothers' Hospital, Brisbane; Royal Brisbane and Women's Hospital, Brisbane; John Hunter Children's Hospital, Newcastle; Royal Prince Alfred Hospital, Sydney; Nepean Hospital, Sydney; Liverpool Hospital, Liverpool; Royal Hospital for Women, Sydney; Royal North Shore Hospital, Sydney; Westmead Hospital, Sydney; The Canberra hospital, Canberra; Mercy Hospital for Women, Melbourne; Monash Medical Centre, Melbourne; The Royal Women's Hospital, Melbourne; Royal Hobart Hospital, Hobart; Flinders Medical Centre, Adelaide; Women's and Children's Hospital, Adelaide; King Edward Memorial Hospital for Women, Perth; Princess Margaret Hospital for Children, Perth.

  • In New Zealand National Women's Health, Auckland; Middlemore Hospital, Auckland; Waikato Hospital, Hamilton; Wellington Regional Hospital, Wellington; Christchurch Women's Hospital, Christchurch; Dunedin Hospital, Dunedin.

  • In Sweden Örebro University hospital, Örebro; Karolinska University Hospital-Astrid Lindgren Solna, Stockholm; Karolinska University Hospital-Huddinge, Stockholm, Sahlgrenska University Hospital, Gothenburg; Linköping University Hospital, Linköping; Norrland University Hospital, Umeå; Uppsala University Hospital, Uppsala; Lund University Hospital, Lund.

  • In Denmark Odense University Hospital, Odense; Rigshospitalet, Copenhagen; Århus University Hospital, Århus.

  • In Finland Helsinki University Central Hospital, Helsinki; Turku University Hospital, Turku; Oulu University Hospital, Oulu; Kuopio University Hospital, Kuopio; Tampere University Hospital, Tampere.

  • In Norway Oslo University Hospital-Rikshospitalet, Oslo; Oslo University Hospital-Ullevål, Oslo; Akershus University Hospital, Lørenskog; Stavanger University Hospital, Stavanger; Haukeland University Hospital, Bergen; Health Sunnmøre Trust, Ålesund, St. Olav University Hospital, Trondheim; Nordland Central Hospital, Bodø; University Hospital of North Norway, Tromsø.

  • Funding KIW is supported in part by a Monash International Postgraduate Research Scholarship. PGD is supported in part by an Australian National Health and Medical Research Council Practitioner Fellowship. The research was funded by Australian National Health and Medical Research Council Program Grant no. 384100.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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