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Updated: Jun 1, 2026
07:36
Mechanical Ventilation Boot Camp Curriculum
Published on: March 12, 2018
Lower back-up rates improve ventilator triggering during assist-control ventilation: a randomized crossover trial.
K I Wheeler1, C J Morley, S B Hooper
1Newborn Research, The Royal Women's Hospital, Melbourne, Victoria, Australia. kevin.wheeler@thewomens.org.au
Summary
Lowering back-up ventilation rates (BURs) in assist-control/volume guarantee ventilation (AC/VG) increases triggered inflations in preterm infants. Patient cardiorespiratory stability remained unaffected across different BUR settings.
Area of Science:
- Neonatal critical care
- Respiratory physiology
- Mechanical ventilation
Background:
- Assist-control/volume guarantee ventilation (AC/VG) is common in preterm infants.
- Back-up ventilation rates (BURs) influence ventilator-patient synchrony.
- Optimizing BURs is crucial for effective respiratory support.
Purpose of the Study:
- To compare the impact of different BURs (30, 40, 50 min⁻¹) on triggered inflations.
- To assess patient cardiorespiratory stability under varying BURs during AC/VG ventilation.
Main Methods:
- Randomized crossover trial in a tertiary Australian NICU.
- 26 stable preterm infants on AC/VG ventilation were studied.
- Ventilator and cardiorespiratory parameters were recorded at different BUR settings.
Main Results:
- Higher triggered inflation proportions observed at lower BURs (85% at 30 min⁻¹ vs. 61% at 50 min⁻¹).
- Total delivered inflation rates increased slightly with higher BURs.
- No significant variations in cardiorespiratory parameters, including CO2 levels, were found across settings.
Conclusions:
- Lowering BURs enhances ventilator-patient triggering during AC/VG.
- Cardiorespiratory stability is maintained across a range of BURs in stable preterm infants.
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