Ventilation

There is a strong respiratory theme in this month's issue. The editor's choice for open access is a meta-analysis of trials of volume – targeted ventilation modes by Peng and colleagues. Evidence from 18 trials enrolling 954 infants is summarised. Compared with pressure – limited ventilation, the use of volume – targeted ventilation modes was associated with a substantial reduction in the risk of air leak, bronchopulmonary dysplasia (BPD), intraventricular haemorrhage and periventricular leukomalacia, There was no effect on mortality. The largest trial included 212 infants and all of the others were very small, so the largest sample size for any individual outcome was 759 infants. It is disappointing that there have not been larger multicentre studies to refine the estimates of benefit but the results for key outcomes show little heterogeneity and are pretty difficult to ignore. The historical experience of trials …