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a Department of Paediatrics (Division of Neonatology),
South Cleveland Hospital, Middlesbrough, Cleveland TS4 3BW, b Department of Radiology, c Department of Pediatrics,
Division of Neonatal-Perinatal Medicine, University of Michigan Medical
Center, Ann Arbor, Michigan, USA
Correspondence to: Dr Sinha.
Accepted 3 June 1997
Fifty preterm infants weighing 1200 g or more with clinical and
radiographic evidence of respiratory distress syndrome, requiring both
mechanical ventilation and exogenous surfactant replacement, were
randomly allocated to receive either volume controlled ventilation or
time cycled, pressure limited ventilation. Tidal volume delivery in
each group was deliberately controlled at 5-8 ml/kg so that the only
difference between the two groups was the ventilatory modality, the
manner in which tidal volume was delivered. The rest of the ventilatory
management and clinical care was done according to protocol. The two
modes of ventilation were compared by determining the time required to
achieve pre-determined success criteria, based on either the
alveolar-arterial oxygen gradient or the mean airway pressure as a
standard against which the speed of weaning could be objectively
assessed. Infants randomised to volume controlled ventilation met
success criteria sooner and had a shorter duration of mechanical
ventilation. These babies also had a significantly lower incidence of
intraventricular haemorrhages and abnormal periventricular
echodensities on ultrasound scans.
Volume controlled ventilation seems to be both safe and effective in
this group of patients.
This article has been cited by other articles:
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