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Proportional assist versus assist control ventilation in premature infants

Sandeep Shetty1, Prashanth Bhat2, Ann Hickey3

  • 1Neonatal Intensive Care Centre, King's College Hospital, London, UK. sandeep.shetty1@nhs.net.

European Journal of Pediatrics
|August 1, 2015
PubMed

Insights

Proportional Assist Ventilation (PAV) improved oxygenation in premature infants compared to Assist Control Ventilation (ACV). This study found PAV beneficial for infants with bronchopulmonary dysplasia (BPD), leading to reduced oxygen and pressure needs.

Area of Science:

  • Neonatalogy
  • Respiratory Medicine
  • Pediatric Critical Care

Background:

  • Proportional Assist Ventilation (PAV) uses servo-controlled pressure for spontaneous breathing.
  • PAV can unload elastic and resistive lung mechanics in infants.
  • Infants with bronchopulmonary dysplasia (BPD) often require mechanical ventilation.

Purpose of the Study:

  • To test if PAV improves oxygenation in premature infants beyond the first week of ventilation compared to ACV.
  • To evaluate the impact of PAV on oxygenation index (OI), inspired oxygen, and mean airway pressure.

Main Methods:

  • A randomized crossover study design was used.
  • Eight premature infants (median gestational age 25 weeks) were studied.
  • Infants received PAV and ACV for 4-hour periods in random order.

Main Results:

  • All eight infants demonstrated superior oxygenation on PAV.
  • PAV was associated with a significantly lower oxygenation index (OI).
  • Inspired oxygen concentration and mean airway pressure were also lower on PAV.

Conclusions:

  • PAV is advantageous in improving oxygenation for premature infants with BPD.
  • PAV may reduce the need for high oxygen concentrations and pressures.
  • These findings support the use of PAV in managing respiratory support for premature infants.

Keywords:
Assist control ventilationOxygenationProportional assist ventilation

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