Editor—The international randomised controlled trial by Dr Baumer1 concluded that there was no benefit of patient triggered ventilation (PTV), but an added risk of increased pneumothorax in those less than 28 weeks gestation. In the same issue, Beresford et al 2 concluded in a similar trial (with slightly more mature newborns 29 weeksv 27), that PTV was feasible with no significant differences noted in medium term outcomes.

Chronic lung disease (CLD) is multifactorial in origin and in Baumer's trial significant factors, like ventilation pressures, intrauterine growth retardation, use of postnatal steroids, and nasal continuous positive airway pressure (nasal CPAP) use, have been not compared between the groups.

Intrauterine growth retardation has been shown to be an important risk factor for CLD.3 In a trial where primary outcome is CLD, omission of the data regarding use of postnatal steroid use is quite surprising. Meta-analysis of the use of dexamethasone in very low birthweight infants has shown marked reduction in CLD at 36 weeks post conceptional age.4 The use of nasal CPAP that has been shown to …