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Neonatal volume guarantee ventilation: effects of spontaneous breathing, triggered and untriggered inflations

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Version 2 2024-06-13, 11:07
Version 1 2019-07-11, 14:52
journal contribution
posted on 2024-06-13, 11:07 authored by N McCallion, R Lau, CJ Morley, PA Dargaville
Background: During volume guarantee (VG) ventilation the peak inflating pressure (PIP) for each ventilator inflation is adjusted to ensure the expired tidal volume (VTe) is close to the set VTe. Differences in the PIP between inflations triggered by the infant's inspirations and untriggered inflations are seen. Aim: To investigate the effects of triggered and untriggered inflations on PIP and VTe. Methods: Neonates were ventilated with the Dräger Babylog 8000 using assist control (synchronous intermittent positive pressure ventilation) and VG modes. Continuous recordings of ventilator pressures and tidal volumes were made at 200 Hz for 10 minutes. Results: In 10 infants, 6540 inflations were analysed, of which 4052 (62%) were triggered. Triggered inflations had a significantly lower mean (SD) PIP than untriggered inflations: 12.9 (4.9) vs 17.0 (3.3) cm H2O, (p<0.001). Despite this, there was no significant difference in the V Te of each type of inflation (103% and 101% of the set V Te, respectively). When a triggered inflation was immediately preceded or followed by an untriggered inflation the PIP changed by about 5 cm H2O. Between adjacent inflations of the same type, the change in PIP was less than 3 cm H2O: for triggered inflations it was 0.11 (1.50) cm H2O and for untriggered inflations 0.06 (1.53) cm H2O. Conclusion: During VG ventilation with the Dräger Babylog 8000 the PIP was 4 cm H2O lower during triggered inflations than untriggered inflations, although the expired tidal volumes were similar.

History

Journal

Archives of disease in childhood: fetal and neonatal edition

Volume

93

Pagination

F36-F39

Location

London, Eng.

Open access

  • Yes

ISSN

1359-2998

eISSN

1468-2052

Language

eng

Publication classification

C1.1 Refereed article in a scholarly journal

Copyright notice

2008, BMJ Publishing Group and Royal College of Paediatrics and Child Health

Issue

1

Publisher

BMJ Publishing Group

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