Article Text

Download PDFPDF
Volume guarantee versus high-frequency ventilation: lung inflammation in preterm infants
  1. G Lista1,
  2. F Castoldi1,
  3. S Bianchi1,
  4. M Battaglioli1,
  5. F Cavigioli1,
  6. M A Bosoni2
  1. 1
    NICU, “Vittore Buzzi” Children’s Hospital, ICP, Milan, Italy
  2. 2
    Laboratory of Biochemistry, “Vittore Buzzi” Children’s Hospital, ICP, Milan, Italy
  1. Dr G Lista, NICU, “Vittore Buzzi” Children’s Hospital, ICP, Via Castelvetro 32, 20154, Milan, Italy; g.lista{at}


Background: Appropriate ventilation together with improvement of clinical care of premature babies can contribute to reducing lung inflammation, known to represent the “primum movens” of bronchopulmonary dysplasia (BPD). High-frequency oscillatory ventilation (HFOV) and volume-guarantee (VG) ventilation are effective in the treatment of neonatal respiratory distress syndrome (RDS).

Objective: To assess the potential of HFOV and VG to prevent BPD in the acute phase of RDS, by a randomised clinical study evaluating lung inflammation in premature infants.

Study design: Forty infants (gestational age 25–32 weeks) with RDS were assigned to assist-control ventilation plus VG (Vt = 5 ml/kg) or HFOV (both with a Dräger Babylog 8000 plus ventilator). Levels of interleukin (IL) 6, IL8 and tumour necrosis factor were determined in tracheal aspirate on days 1, 3 and 7 of life.

Results: In the HFOV group IL6 levels were significantly higher on day 3 (0.5 (0.2) vs assisted-control ventilation plus VG group 0.1 (0.2) ng/ml) and oxygen dependency was significantly longer (36 (23) vs assisted-control ventilation plus VG group 19 (11) days).

Conclusion: VG ventilation is an effective lung-protective strategy to be used in acute RDS, inducing a lower expression of early inflammation markers than HFOV. Whether the use of this initial ventilatory strategy contributes to the prevention of BPD requires further studies.

Statistics from

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.


  • Competing interests: None.

  • Ethics approval: Approval from the ethics committee of Azienda ICP, Milan, Italy was obtained.

Linked Articles

  • Fantoms
    Martin Ward Platt