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Spontaneous respiratory effort during mechanical ventilation in infants with and without acute respiratory distress

M F Hird1, A Greenough

  • 1Dept. of Child Health, King's College Hospital, London, U.K.

Early Human Development
|May 1, 1991
PubMed

Insights

Mechanical ventilation in preterm infants recovering from respiratory distress syndrome (RDS) is effective. Spontaneous respiratory efforts have minimal impact on outcomes after acute RDS, with synchrony achievable via ventilator adjustments.

Area of Science:

  • Neonatal physiology
  • Respiratory medicine
  • Pediatric critical care

Background:

  • Acute respiratory distress syndrome (RDS) is a common complication in preterm infants.
  • Mechanical ventilation is a critical support measure for these infants.
  • Understanding respiratory interactions is key to optimizing ventilator support.

Purpose of the Study:

  • To assess the effect of spontaneous respiratory efforts on mechanical ventilation outcomes in preterm infants recovering from acute RDS.
  • To determine the influence of postnatal age on respiratory interactions during mechanical ventilation.

Main Methods:

  • Daily recording of respiratory interactions in 27 ventilated preterm infants over 14 days.
  • Observation of spontaneous respiratory efforts, active expiration, and synchrony with the ventilator.
  • Analysis of ventilator rates (30, 60, 90, 120 breaths/min) for optimal interaction.

Main Results:

  • Active expiration and persistent asynchrony were significantly associated with acute RDS (P < 0.01).
  • A synchronizing ventilator rate was found for most infants making respiratory efforts.
  • Apnea became more prevalent with increasing postnatal age (P < 0.01).

Conclusions:

  • Preterm infants' spontaneous respiratory efforts have a limited influence on mechanical ventilation outcomes post-RDS recovery.
  • Ventilator rate adjustments can achieve synchrony, but apnea increases with age.
  • Optimizing ventilator settings is crucial for managing preterm infants with respiratory distress.

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