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

Suhas M. Nafday, Robert S. Green, Jing Lin, Luc P. Brion, Ian Ochshorn, Ian R. Holzman

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

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 sufactant-treated premature newborns with RDS except for minimizing the number of blood gases.

Original languageEnglish (US)
Pages (from-to)193-197
Number of pages5
JournalJournal of Perinatology
Volume25
Issue number3
DOIs
StatePublished - Mar 2005

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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