Introduction Volume guarantee (VG) ventilation is frequently used for newborns, mostly combined with SIMV or A/C modes. Aim of this study was to compare effect of SIMV+VG or PSV+VG ventilation on ventilatory and laboratory parameters and clinical findings.
Patients and methods Preterms with RDS < 34thgestational age (GA)requiring mechanical ventilation in the first 12 h were randomised to either SIMV+VG or PSV+VG after surfactant treatment. Patients were ventilated with Draeger Babylog 8000+. Set and measured ventilatory parameters were downloaded by Babyview® software for 72 h unless extubation or need for HFO ventilation occurred. Actual peak inspiratory pressure (PIP), set and measured tidal volume (TV), mean airway pressure (MAP) and FiO2 were analysed. If measured TV percentage was between 80–120% of set TV, it was considered appropriate.
Results 42 patients (21 PSV+VG, 21 SIMV+VG) were enrolled. Median GA were 29 weeks and BW were 980,0 and 870,0 gr in each group. Demographic characteristics were similar. ‘Appropriate TV’ was higher in PSV+VG group. PIP, MAP and FiO2 were similar in two groups. Hypocarbia, hypercarbia, hyperoxemia and hypoxemia incidences were not different. PSV+VG group were less tachycardic than SIMV+VG group. Acute and chronic prematurity problems including chronic lung disease (CLD) defined as oxygen requirement at 36th GA were not different.
Conclusion PSV+VG was associated with higher ‘appropriate TV’ without any adverse effects and similar CLD occurence. These findings can support the beneficial use of PSV+VG which is more physiologic due to better inspiratory – expiratory synchrony.