[Prognostic criteria of the premature infants weaning from mechanical ventilation during trigger ventilation]

Modern mechanical ventilation modes do not prevent ventilator-associated lung injury therefore respiratory cessation must be stopped as soon as possible. However extubation recommendations absence makes difficulties in process of weaning the infants from the mechanical ventilation.

To assess the prognostic criteria of the extubating and weaning from mechanical ventilation in premature infants during trigger ventilation (PSV/PSV + VG).

66 Pediatric patients were divided into two groups during the period of weaning from mechanical ventilation: PSV + PG ventilation mode was used in the group 1 (n = 33), and PSV in the group 2 (n = 33). Basic characteristics were same in both groups: gestational age 31.1 +/- 2.5 weeks, mass of body 1586.2 +/- 356.8 grams. Extubation was successful if reintubation was not needed during 48 hrs.

90% of successful extubations were done when the compliance was over 1.1 ml mbar(-1). Compliance decrease under 0.75 ml mbar(-1) was an adverse prognostic criterion of the weaning from mechanical ventilation and extubation. Index breathing rate/breathing volume (RVR) can be used as general criterion of the weaning from mechanical ventilation. Progressive RVR increase to 8 is an adverse prognostic criterion of PSV/ PSV + VG mode use during the period of weaning from mechanical ventilation. Parameters of mechanical ventilation which maintain acceptable gas composition of blood and SpO2 mast be considered before extubation.

Positive dynamics and stabilization of compliance and resistance are essential criteria of the successful weaning from mechanical ventilation and extubation. RVR can be used as objective criterion of an extubation.