Objective: In a randomised trial, pressure support with synchronised intermittent mandatory ventilation (SIMV) compared to SIMV alone was associated with a significant reduction in supplementary oxygen duration. The hypothesis that the addition of pressure support to SIMV compared to SIMV alone would reduce the work of breathing was examined.
Design: Prospective study.
Setting: Perinatal service.
Patients: 20 infants, with a mean gestational age of 31 weeks, being weaned from mechanical ventilation were studied.
Interventions: 1 h periods of SIMV and SIMV with pressure support at 50% of the difference between the peak inflating pressure and positive end expiratory pressures.
Main outcome measures: The work of breathing was assessed by measurement of the transdiaphragmatic pressure time product (PTPdi).
Results: The mean PTPdi on SIMV plus pressure support was 112 cm H2O.s/min, approximately 20% lower than that on SIMV alone (141 cm H2O.s/min) (p<0.001).
Conclusion: The addition of pressure support to SIMV reduces the work of breathing in infants being weaned from the ventilator.
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Funding: Dr Patel is supported by The Charles Wolfson Charitable Trust.
Competing interests: AG has held grants and received honoraria for giving lectures and advising various ventilator manufacturers.
Ethics approval: This study was approved by the King’s College Hospital Research Ethics Committee.
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