Availability of Volume Guaranteed Ventilation in Very Low Birth Weight Infants

Kim, Ji Eun; Kwon, Eun Young; Wen, Sheng; Jung, Jin A; Lee, Young Ah; Kim, Jung Pyo

Abstract

PURPOSE: During the last few decades, very low birth weight (VLBW) infants had been treated with time-cycled pressure-limited ventilation. According to a recent study, however, lung damage is much more likely following volutrauma rather than barotrauma. Therefore, other researchers have started to study volume-guaranteed (VG) ventilation as a new method for infant respiratory distress syndrome. The aims of this study are to compare the effects and safety of VG ventilation with conventional intermittent mandatory ventilation (IMV) on mechanical ventilation in VLBW infants with respiratory distress syndrome (RDS).
METHODS
A prospective study was performed from Jan, 2005 to Jun, 2006 in Dong-A University Medical Center NICU on 28 VLBW infants who were diagnosed with respiratory distress syndrome. The infants were randomly assigned to IMV or VG ventilation. The IMV and VG groups consisted of sixteen and twelve patients, respectively. We compared arterial blood gas analysis (ABGA), fraction of inspired oxygen (FiO2), peak inspiratory pressure (PIP), mean airway pressure (MAP) and ventilation index (VI) between the two groups during the four days after their birth.
RESULTS
The mean gestational age of our infant patients was 27.8 (+/-2.2) weeks in the VG group and 27.7 (+/-2.3) weeks in the IMV group; the mean birth weight was 1103 (+/-239.1) g and 1061.2 (+/-322.4) g, respectively (P>0.05). Although the two groups had a similar FiO2 and VI, PIP and MAP were significantly lower in VG than IMV during the study pediod (P<0.001). There was no significant difference in the complications between the two groups.
CONCLUSION
In this study, PIP and MAP are significantly lower in VG group than IMV group. These findings suggest that the new VG ventilation could reduce lung damage in VLBW infants with RDS. To achieve more effective results, this study needs to continue a long term study with a greater number of subjects.