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Patient triggered ventilation in chronically ventilator-dependent infants

M F Hird1, A Greenough

  • 1Department of Child Health, King's College Hospital, London, United Kingdom.

European Journal of Pediatrics
|August 1, 1991
PubMed

Insights

Patient triggered ventilation (PTV) using an airway pressure trigger infrequently supports infants needing long-term mechanical ventilation. Most infants failed to maintain PTV due to inadequate respiratory efforts and asynchrony.

Area of Science:

  • Neonatal Medicine
  • Pediatric Critical Care
  • Respiratory Physiology

Background:

  • Mechanical ventilation is essential for preterm infants with respiratory failure.
  • Prolonged ventilator dependence poses significant challenges in neonatal care.
  • Patient triggered ventilation (PTV) aims to improve synchrony between infant and ventilator.

Purpose of the Study:

  • To evaluate the efficacy of patient triggered ventilation (PTV) with an airway pressure trigger in ventilator-dependent preterm infants.
  • To identify factors predicting successful PTV use and reasons for failure.

Main Methods:

  • A cohort of 16 preterm infants requiring mechanical ventilation beyond the first week of life were studied.
  • PTV was delivered using a ventilator with an airway pressure trigger.
  • Infant-ventilator synchrony and trigger delay were assessed.

Main Results:

  • PTV was successfully maintained until extubation in only 3 out of 16 infants.
  • Failure occurred in 13 infants within a median of 1 hour, often due to inadequate respiratory efforts or asynchrony.
  • Successful PTV use was associated with older infants, greater maturity, higher birth weight, and shorter trigger delay.

Conclusions:

  • Airway pressure-triggered PTV is infrequently successful in providing adequate respiratory support for chronically ventilator-dependent preterm infants.
  • Infant-ventilator asynchrony within the first hour is a predictor of PTV failure.

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