HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Free to Access Full Text Full Text (PDF) All Versions of this Article: adc.2007.126284v1 93/1/F36    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in ADC Online Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by McCallion, N Articles by Dargaville, P A Search for Related Content PubMed PubMed Citation Articles by McCallion, N Articles by Dargaville, P A Topic Collections Related Article

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

¹ Neonatal Services, Royal Women’s Hospital, Melbourne, Victoria, Australia
² Department of Neonatology, Royal Hobart Hospital, Tasmania, Australia
³ Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
⁴ Neonatal Intensive Care Unit, National Maternity Hospital, Dublin, Ireland

Correspondence to:
Dr N McCallion, Neonatal Intensive Care Unit, National Maternity Hospital, Holles St, Dublin 2, Ireland; n.mccallion{at}bristol.ac.uk

Background: During volume guarantee (VG) ventilation the peak inflating pressure (PIP) for each ventilator inflation is adjusted to ensure the expired tidal volume (V_Te) is close to the set V_Te. 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 V_Te.

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.