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Volume Guarantee Ventilation: Effect on Preterm Infants with Frequent Hypoxemia Episodes
Deepak Jain1, Nelson Claure, Carmen D'Ugard
1Division of Neonatology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Fla., USA.
Volume guarantee (VG) ventilation modestly reduced hypoxemia episode duration in preterm infants but did not decrease severe events. This mode also lowered the fraction of inspired oxygen (FiO2) compared to pressure control (PC) ventilation.
Area of Science:
- Neonatalogy
- Pediatric critical care
- Respiratory physiology
Background:
- Preterm infants on mechanical ventilation often experience hypoxemia episodes (HE) due to decreased lung and tidal volumes (VT).
- Volume guarantee (VG) ventilation adjusts peak pressure to maintain target exhaled VT, but its clinical impact on HE is not fully understood.
Purpose of the Study:
- To compare the effect of VG versus pressure control (PC) ventilation on hypoxemia episodes in mechanically ventilated preterm infants under routine clinical conditions.
Main Methods:
- Twenty-four preterm infants with frequent hypoxemia episodes (SpO2 <75%) were studied over two 24-hour periods using VG and PC ventilation in random order.
Main Results:
- The frequency of HE (SpO2 <85%) did not differ, but their duration was shorter with VG. Severe HE (SpO2 <75%) frequency and duration were similar between VG and PC. The fraction of inspired oxygen (FiO2) was lower during VG.
- The proportion of time spent in severe hypoxemia (SpO2 <75%) was not significantly different between the two ventilation modes.
Conclusions:
- Volume guarantee ventilation offers a modest benefit by reducing the duration of hypoxemia episodes (SpO2 <85%) and lowering FiO2 requirements in preterm infants.
- VG ventilation did not demonstrate a reduction in the frequency or duration of severe hypoxemia (SpO2 <75%) compared to PC ventilation.
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