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Volume guarantee versus high-frequency ventilation: lung inflammation in preterm infants

G Lista1, F Castoldi, S Bianchi

  • 1NICU, Vittore Buzzi Children's Hospital, ICP, Via Castelvetro 32, 20154, Milan, Italy. g.lista@icp.mi.it

Archives of Disease in Childhood. Fetal and Neonatal Edition
|April 5, 2007
PubMed

Insights

Volume-guarantee (VG) ventilation is a lung-protective strategy for premature infants with respiratory distress syndrome (RDS). VG ventilation showed lower inflammation markers compared to high-frequency oscillatory ventilation (HFOV).

Area of Science:

  • Neonatal Medicine
  • Pediatric Respiratory Medicine
  • Critical Care

Background:

  • Bronchopulmonary dysplasia (BPD) is a significant concern in premature infants, often initiated by lung inflammation.
  • High-frequency oscillatory ventilation (HFOV) and volume-guarantee (VG) ventilation are established treatments for neonatal respiratory distress syndrome (RDS).

Purpose of the Study:

  • To evaluate the efficacy of HFOV and VG ventilation in preventing BPD during the acute phase of RDS.
  • To compare lung inflammation markers in premature infants treated with HFOV versus VG ventilation.

Main Methods:

  • A randomized clinical study involving 40 premature infants (25-32 weeks gestational age) with RDS.
  • Infants were assigned to either assist-control ventilation with VG (tidal volume 5 ml/kg) or HFOV.
  • Interleukin (IL)-6, IL-8, and tumor necrosis factor levels were measured in tracheal aspirates on days 1, 3, and 7.

Main Results:

  • The HFOV group exhibited significantly higher IL-6 levels on day 3 compared to the VG group.
  • Infants in the HFOV group required longer oxygen dependency (36 days) than those in the VG group (19 days).

Conclusions:

  • Volume-guarantee (VG) ventilation demonstrates effectiveness as a lung-protective strategy in acute RDS.
  • VG ventilation resulted in lower expression of early inflammation markers compared to HFOV.
  • Further research is needed to confirm if this initial ventilatory strategy prevents BPD.
Abstract

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