Influence of lung function and reflex activity on the success of patient-triggered ventilation

The influence of lung function and reflex activity on the success of patient-triggered ventilation (PTV) has been determined. Lung function was assessed by measurement of compliance using a single breath technique. Reflex activity was assessed by measurement of the strength of Hering Breuer reflex indicated by the degree of prolongation of expiration following end inspiratory occlusion. PTV was considered to have failed if the infant became apnoeic or required an increased level of respiratory support. Twenty premature infants (median gestational age 29 weeks) in the recovery stage of respiratory distress, were studied at a median postnatal age of 2.5 days. PTV failed ultimately in six infants, although compliance of the respiratory system of that group did not differ significantly from the rest of the cohort, their Hering Breuer reflex was significantly weaker (P < 0.01). In addition, the infants in whom PTV failed were significantly more immature and of lower birthweight (P < 0.01) compared with those in whom it succeeded. We conclude that failure of PTV is more likely in immature infants who have a weak Hering Breuer reflex.