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Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
07:52

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Published on: January 29, 2011

Randomised study comparing extent of hypocarbia in preterm infants during conventional and patient triggered

K Luyt1, D Wright, J H Baumer

  • 1Child Health Department, Derriford Hospital, Derriford Road, Plymouth PL6 8DH, Devon, UK. kluyt@doctors.org.uk

Archives of Disease in Childhood. Fetal and Neonatal Edition
|December 23, 2000
PubMed

Insights

Patient triggered ventilation (PTV) and conventional mechanical ventilation (CMV) did not significantly differ in causing hypocarbia in premature infants. Hypocarbia was common in the first two days, particularly in infants needing less ventilatory support.

Area of Science:

  • Neonatalogy
  • Pediatric Critical Care
  • Respiratory Physiology

Background:

  • Premature infants often require mechanical ventilation.
  • Hypocarbia, a state of low carbon dioxide levels, is a potential complication of ventilation.
  • Patient triggered ventilation (PTV) is an alternative mode to conventional mechanical ventilation (CMV).

Purpose of the Study:

  • To compare the incidence of significant hypocarbia between PTV and CMV in premature infants.
  • To identify risk factors for hypocarbia in the first 72 hours of life.

Main Methods:

  • A randomized controlled trial included infants with a gestational age of 32 weeks or less.
  • 74 infants were assigned to PTV and 68 to CMV.
  • Arterial blood gases (PaCO2) were measured every four hours for the initial 72 hours.

Main Results:

  • No significant difference in mean PaCO2 levels or the proportion of infants with hypocarbia (PaCO2 ≤ 3.33 kPa) between PTV and CMV groups.
  • Hypocarbia was prevalent on day 1 (31.4%) and day 2 (18.9%) in both groups.
  • Lower peak inspiratory pressure (< 14 cm H2O) and FiO2 (< 0.30) were associated with increased risk of hypocarbia on day 1.

Conclusions:

  • PTV and CMV do not differ in their risk of causing hypocarbia in preterm infants.
  • Hypocarbia is a common issue in the early days of ventilation for preterm neonates.
  • Infants requiring less ventilatory support may be at higher risk; aggressive weaning and extubation are recommended.
Abstract

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