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Is there an Advantage of Using Pressure Support Ventilation with Volume Guarantee in the Initial Management of Premature Infants with Respiratory Distress Syndrome? A pilot study

Abstract

OBJECTIVE:

To evaluate the feasibility of using the pressure support ventilation with volume guarantee (PSV-VG) as an initial ventilatory mode in preterm infants with respiratory distress syndrome (RDS) after surfactant treatment to achieve accelerated weaning of peak inspiratory pressure (PIP) and mean airway pressure (MAP).

STUDY DESIGN:

Initial 24-hour ventilatory parameters were compared in two groups of preterm infants managed by PSV-VG and the synchronized intermittent mandatory ventilation (SIMV) mode in a randomized controlled pilot study after surfactant treatment for RDS. A total of 16 babies were randomized to PSV-VG (1198±108 g [mean±SEM]; 27.9±0.6 weeks) and 18 babies to SIMV (birth weight 1055±77 g; gestational age 27.4±0.5 weeks). Repeated measures analysis of variance was used to compare serial values of PIP and MAP in the two groups.

RESULTS:

The PIP and MAP decreased over time (p<0.001) during the first 24 hours after surfactant administration in both groups but the decrease in MAP was faster in the SIMV group compared to PSV-VG group (p=0.035). The median numbers of blood gases during the first 24 hours were four and two in the SIMV and PSV-VG groups, respectively (p<0.001). The overall outcomes were not significantly different between the two groups.

CONCLUSION:

PSV-VG did not offer any ventilatory advantage over SIMV in the initial management of surfactant-treated premature newborns with RDS except for minimizing the number of blood gases.

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Additional information

The study was supported in part by a fellowship grant “Advancing Newborn Medicine” to Suhas M. Nafday from Forest Pharmaceuticals Inc. No products from the company were used during this study.

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Nafday, S., Green, R., Lin, J. et al. Is there an Advantage of Using Pressure Support Ventilation with Volume Guarantee in the Initial Management of Premature Infants with Respiratory Distress Syndrome? A pilot study. J Perinatol 25, 193–197 (2005). https://doi.org/10.1038/sj.jp.7211233

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