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Related Experiment Videos

Crossover trial comparing pressure support with synchronized intermittent mandatory ventilation.

Steven L Olsen1, Donald W Thibeault, William E Truog

  • 1Department of Pediatrics, Section of Neonatology, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64108, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|August 9, 2002
PubMed
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Pressure support ventilation with volume guarantee (PSV+VG) increased minute ventilation in infants with respiratory distress syndrome (RDS) but did not improve oxygenation or compliance compared to synchronized intermittent mandatory ventilation (SIMV). Routine use is not recommended.

Area of Science:

  • Neonatal medicine
  • Pediatric respiratory care
  • Mechanical ventilation strategies

Background:

  • Respiratory distress syndrome (RDS) is a common condition in premature infants.
  • Mechanical ventilation is crucial for managing RDS, with various modes available.
  • Optimizing ventilation strategies is essential to minimize lung injury and improve outcomes.

Purpose of the Study:

  • To compare the efficacy of pressure support ventilation with volume guarantee (PSV+VG) against synchronized intermittent mandatory ventilation (SIMV) in infants diagnosed with RDS.
  • To assess key respiratory parameters including minute ventilation, carbon dioxide levels, airway pressure, oxygenation, and lung compliance under both ventilation modes.

Main Methods:

  • A randomized, crossover study design was employed.

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  • Fourteen infants with RDS (birth weight 2.5±0.7 kg, gestational age 34±2 weeks) were enrolled.
  • Each infant received 4 hours of ventilation with PSV+VG and 4 hours with SIMV, with the initial mode randomized. End-expiratory volume (EEV) was measured.

    • Main Results:

    • Minute ventilation (V(E)) was significantly higher with PSV+VG compared to SIMV (p=0.012).
    • Mean airway pressure was also higher during PSV+VG ventilation (p=0.023).
    • No significant differences were observed in partial pressure of carbon dioxide (p(a)CO(2)), arterial/alveolar oxygen tension (a/A) ratio, or specific dynamic compliance (sCdyn) between the two modes.

    Conclusions:

    • While PSV+VG led to increased minute ventilation in infants with RDS, it did not offer advantages in oxygenation or lung compliance over SIMV.
    • The lack of demonstrated benefit in key respiratory parameters suggests that routine use of PSV+VG may not be advantageous for this patient population.
    • Further research may be needed to identify specific subgroups of RDS infants who might benefit from PSV+VG or to refine its application.