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Pressure-regulated volume control ventilation vs synchronized intermittent mandatory ventilation for very

Carl T D'Angio1, Patricia R Chess, Stephen J Kovacs

  • 1Strong Children's Research Center, University of Rochester, Rochester, NY 14642, USA. carl_dangio@urmc.rochester.edu

Archives of Pediatrics & Adolescent Medicine
|September 7, 2005
PubMed

Insights

Pressure-regulated volume control (PRVC) did not improve survival or extubation rates in very low-birth-weight infants compared to synchronized intermittent mandatory ventilation (SIMV). Both ventilation modes showed similar outcomes for infants requiring mechanical ventilation.

Area of Science:

  • Neonatalogy
  • Pediatric Critical Care
  • Respiratory Support

Background:

  • Mechanical ventilation is crucial for very low-birth-weight infants.
  • Optimizing ventilator settings is essential to improve outcomes and reduce complications.
  • Assist/control modes like PRVC are alternatives to conventional modes like SIMV.

Purpose of the Study:

  • To compare the efficacy of pressure-regulated volume control (PRVC) versus synchronized intermittent mandatory ventilation (SIMV) in very low-birth-weight infants.
  • To determine if PRVC increases the proportion of infants alive and extubated at 14 days of age.
  • To assess secondary outcomes including duration of ventilation and need for supplemental oxygen.

Main Methods:

  • Randomized controlled trial involving ventilated infants with birth weights between 500 and 1249 g.
  • Infants were assigned to either SIMV or PRVC ventilation modes shortly after birth.
  • Ventilator mode assignment continued until extubation, death, or failure criteria were met.

Main Results:

  • No significant difference was observed in the proportion of infants alive and extubated at 14 days between PRVC and SIMV groups (37% vs 41%).
  • Secondary outcomes, including mechanical ventilation duration in survivors and survival without supplemental oxygen at 36 weeks' postmenstrual age, were also similar.
  • A higher rate of ventilator mode failure was noted in the SIMV group (33%) compared to the PRVC group (20%).

Conclusions:

  • Pressure-regulated volume control (PRVC) ventilation initiated at birth did not improve time to extubation in mechanically ventilated infants weighing 500 to 1249 g.
  • The study found no significant advantage of PRVC over SIMV for key neonatal respiratory support outcomes.
  • While PRVC showed a lower failure rate, this did not translate to improved overall clinical outcomes at 14 days.
Abstract

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