Abstract
The importance of the preterm infant's inspiratory time in determining the optimum inflation time during mechanical ventilation was investigated. The optimum inflation time was defined as that which was most commonly associated with synchronous respiration and maximum minute volume. Twelve preterm infants were studied on 14 occasions. They were ventilated at rates of 60, 75, 90, 105 and 120 breaths/min, with an inspiratory: expiratory ratio of 1∶1.2. These rates were chosen as they resulted in inflation times approximating to the spontaneous inspiratory time measured during a brief period of disconnection, on continuous positive airways pressure (CPAP), and greater than that measured on CPAP. Inspiratory time during disconnection was always shorter than that measured on CPAP (P<0.01). Synchrony was most commonly provoked and minute volume greatest at the shortest inflation time (P<0.01). We conclude fast ventilator rates are most efficacious for preterm neonates. As previously shown, this rate can be estimated by examining the standard reference range of rates in relation to gestational age.
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Abbreviations
- CPAP:
-
continuous positive airways pressure
References
Field DJ, Milner AD, Hopkin IE (1984) High and conventional rates of positive pressure ventilation. Arch Dis Child 59: 1151–1155
Froese AB, Bryan AC (1987) High frequency ventilation. Am Rev Respir Dis 135:1363–1374
Greenough A, Greenall F (1988) Observation of spontaneous respiratory interaction with artificial ventilation. Arch Dis Child 63:168–171
Greenough A, Morley CJ, Pool J (1986) Fighting the ventilator — are fast rates an effective alternative to paralysis? Early Hum Dev 13:189–194
Greenough A, Pool J, Geenall F, Morley CJ, Gamsu H (1987) Comparison of different rates of artificial ventilation in preterm neonates with the respiratory distress syndrome. Acta Paediatr Scand 76:706–712
Greenough A, Greenall F, Gamsu H (1987) Synchronous respiration — which ventilator rate is best? Acta Paediatr Scand 76:713–718
Heicher DA, Kastings DS, Richards JR (1981) Prospective clinical comparison of two methods for mechanical ventilation of neonates: rapid rate and short inspiratory time versus slow rate and long inspiratory time. J Pediatr 98:957–961
Lagneaux D, Mossay C, Genselle F, Christiaens G (1988) Alveolar data in healthy, awake neonates during spontaneous ventilation: a preliminary investigation. Pediatr Pulmonol 5:255–231
Martin RJ, Okken A, Katona PG, Klaus MH (1978) Effect of lung volume on expiratory time in the newborn infant. J Appl Physiol 45:18–23
Pohlandt F, Beinsau V, Fielen KD, Hörnchen H, Leonhardt A, Oppermann H-C, Pringsheim W, Saule H, Schröder H, Wolff C (1985) Reduction in barotrauma in ventilated infants by increase in ventilation frequency. First results of a prospective collaborative and randomised trial of two different ventilator techniques. Pediatr Res 19:1077
Sankaran K, Leahy FN, Cates D, Macallum M, Rigatto H (1981) Effect of lung inflation on ventilator and various phases of the respiratory cycle in preterm infants. Biol Neonate 40:160–166
South M, Morley CJ (1986) Synchronous mechanical ventilation in the neonate. Arch Dis Child 61:1190–1196
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Hird, M., Greenough, A. Inflation time in mechanical ventilation of preterm neonates. Eur J Pediatr 150, 440–443 (1991). https://doi.org/10.1007/BF02093728
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DOI: https://doi.org/10.1007/BF02093728