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Volume-controlled ventilation is made possible in infants by using compliant breathing circuits with large
M Badgwell1, J Swan, A C Foster
1Department of Anesthesiology, Texas Tech University Health Sciences Center, Lubbock 79430, USA.
Anesthesia and Analgesia
|April 1, 1996
Summary
Set tidal volume (VTset) in infants during mechanical ventilation depends on weight, with smaller infants requiring higher volumes per kilogram. This study highlights the importance of compliant breathing systems for effective ventilation in neonates.
Area of Science:
- Anesthesiology
- Pediatric Critical Care
- Respiratory Physiology
Background:
- Volume-controlled ventilation is crucial for infants undergoing surgery.
- Understanding tidal volume requirements based on patient weight is essential for safe anesthesia.
- Various breathing circuits can influence delivered volumes in pediatric patients.
Purpose of the Study:
- To investigate the weight dependency of set tidal volume (VTset) in infants during volume-controlled ventilation.
- To evaluate the impact of different breathing circuits and ventilator settings on delivered tidal volumes.
- To establish a relationship between infant weight and appropriate tidal volume settings.
Main Methods:
- Studied 80 infants (0.7-20 kg) with varying ASA physical status undergoing major and minor surgeries.
- Utilized an Ohmeda 7800 volume-limited ventilator with pediatric/adult circle or Bain circuits and bellows.
- Monitored body weight, age, peak inspiratory pressure (PIP), ETCO2, and SPO2.
Main Results:
- A curvilinear relationship was observed between VTset/kg and infant weight (y = 175.02x-0.87; r2 = 0.87).
- VTset was approximately 150-200 mL/kg for 1-kg infants and 25 mL/kg for infants >= 10 kg.
- Large compression volume losses were noted across tested circuits, with adequate ventilation achieved in most infants.
Conclusions:
- Set tidal volume requirements per kilogram decrease significantly with increasing infant weight.
- Compliant breathing systems are vital for accurate volume delivery in small infants using volume-controlled ventilators.
- This research provides a basis for optimizing ventilator settings in pediatric anesthesia.