Related Experiment Videos
Flow-synchronized ventilation of preterm infants with respiratory distress syndrome
S M Donn1, J J Nicks, M A Becker
1Department of Pediatrics, University of Michigan Medical Center, Ann Arbor.
Insights
Patient-triggered, flow-synchronized ventilation significantly reduced mechanical ventilation duration in preterm infants with respiratory distress syndrome. This approach also lowered patient charges without increasing complications.
Area of Science:
- Neonatal Medicine
- Pediatric Respiratory Care
- Medical Engineering
Background:
- Asynchrony between delivered and spontaneous breaths in mechanically ventilated infants can negatively impact gas exchange.
- This asynchrony may prolong the duration of assisted ventilation in preterm infants.
Purpose of the Study:
- To evaluate the efficacy of patient-triggered, flow-synchronized ventilation compared to conventional ventilation.
- To assess the impact on time to extubation and patient charges.
Main Methods:
- A randomized controlled trial involving 30 preterm infants (1100-1500 gm) with respiratory distress syndrome requiring mechanical ventilation.
- Infants were assigned to either conventional time-cycled, pressure-limited ventilation or patient-triggered, flow-synchronized ventilation.
Main Results:
- Flow-synchronized ventilation significantly reduced the mean time to extubation (119 hours) compared to conventional ventilation (271 hours).
- No significant difference in complication rates was observed between the groups.
- Patient charges were reduced by $4344 per patient in the flow-synchronized ventilation group.
Conclusions:
- Patient-triggered, flow-synchronized ventilation facilitates faster weaning in preterm infants with respiratory distress syndrome.
- This ventilation mode offers a potential cost-saving benefit without compromising patient safety.
Abstract:
Asynchrony of delivered and spontaneous breaths in mechanically ventilated infants may impair gas exchange and prolong the need for assisted ventilation. We conducted a randomized, controlled trial of a patient-triggered, flow-synchronized ventilator on 30 preterm infants with respiratory distress syndrome who weighed between 1100 and 1500 gm at birth. Entry criteria included radiographic evidence of respiratory distress syndrome and the need for mechanical ventilation and surfactant replacement therapy. Patients were assigned to either conventional time-cycled, pressure-limited ventilation or patient-triggered, flow-synchronized ventilation in an assist/control mode. Otherwise clinical management was identical. Time to extubation was the primary outcome measure. Patients treated with flow-synchronized ventilation were weaned more rapidly and had a significantly shorter mean time to extubation than those treated with time-cycled, pressure-limited ventilation, 119 versus 271 hours, p = 0.0152. In addition, there was no difference in the rate of complications between the two groups. There were, however, considerable reductions in patient charges of $4344 per patient in the flow-synchronized ventilation group.