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Published on: November 2, 2015
Volume guarantee ventilation in neonates treated with hypothermia for hypoxic-ischemic encephalopathy during
Lajos Lantos1,2, Aniko Berenyi1, Colin Morley2
1Neonatal Emergency and Transport Service of the Peter Cerny Foundation, Budapest, Hungary.
Objective:
We investigated if volume guarantee (VG) ventilation in babies with hypoxic-ischemic encephalopathy (HIE) during interhospital transport decreases tidal volumes and prevents hypocapnia.
Study Design:
We computationally collected and analyzed ventilator data of babies ventilated with synchronized intermittent mandatory ventilation (SIMV) with VG (n = 28) or without VG (n = 8).
Result:
The expiratory tidal volume of ventilator inflations was lower with SIMV-VG (median [IQR]: 4.9 [4.6-5.3] mL/kg) than with SIMV only (median [IQR]: 7.1 [5.3-8.0] mL/kg, p = 0.01). Babies receiving SIMV-VG had lower peak inflating pressures (median: 10.7 cmH2O, versus 17.5 cmH2O, p = 0.01). There was no significant difference in minute ventilation or in pCO2. Babies with strong spontaneous breathing had a mean PIP < 10 cmH2O but this did not result in adverse events or worsening of acidosis.
Conclusions:
The use of VG ventilation in babies with HIE reduces tidal volumes and frequently results in very low inflating pressures without affecting pCO2.
