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Adaptive mechanical backup ventilation for preterm infants on respiratory assist modes - a pilot study
Susanne Herber-Jonat1, Esther Rieger-Fackeldey2, Helmut Hummler3
1Department of Obstetrics and Gynecology, Division of Neonatology, Klinikum Großhadern, University of Munich, Marchioninistrasse 15, 81377, Munich, Germany. susanne.jonat@med.uni-muenchen.de.
Intensive Care Medicine
|January 25, 2006
Summary
A new adaptive backup ventilation system for preterm infants significantly reduced oxygen desaturations. This SpO2-sensitive backup support proved safe and effective, improving gas exchange during mechanical ventilation.
Area of Science:
- Neonatal respiratory support
- Mechanical ventilation
- Preterm infant care
Background:
- Mechanical respiratory-assist modes require continuous infant effort.
- Periodic breathing and apnea necessitate backup ventilation to maintain gas exchange.
- Conventional mechanical ventilation uses an "on/off" approach for backup support.
Purpose of the Study:
- To develop and evaluate an adaptive mechanical backup ventilation mode.
- The mode aims to adjust to the rapidly changing breathing patterns of preterm infants.
Main Methods:
- Prospective randomized clinical crossover trial conducted in a neonatal intensive care unit.
- Preterm infants undergoing proportional assist ventilation (PAV) were studied.
- Infants received PAV with a new adaptive backup support, with and without pulse-oximetry-guided (SpO2-sensitive) operation, in a randomized sequence.
Main Results:
- The SpO2-sensitive adaptive backup support significantly reduced the incidence of oxygen desaturations by 33%.
- A 52% reduction in the duration of oxygen desaturations was observed with the adaptive backup support.
- The study included 11 preterm infants.
Conclusions:
- SpO2-sensitive adaptive backup ventilation is safe and effective for preterm infants.
- This technology reduces the incidence and duration of oxygen desaturation.
- Potential applicability to other assisted ventilation modalities, like noninvasive nasal ventilation, is suggested.
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