Résumé
Objectives: To evaluate the efficiency of volume targeted versus pressure-limited ventilation for preterm infants with respiratory distress
Methods: 60 newborn infants with gestational age 28-34 weeks in the NICU at Alexandria University Children's Hospital randomly divided in to 2 groups ventilated with either volume targeted ventilation [VTV] or pressure limited time cycled ventilation [PLV] as primary mode or secondary to failure of NCPAP using SLE 4000 or 5000 ventilators
Results: The demographic and clinical characteristics, values of tidal volume [VT], peak inspiratory pressure [PIP], mean airway pressure [MAP], fraction of inspired oxygen [Fio2], alveolar arterial oxygen gradient [A-aDo2], carbon dioxide tension, and pH were similar for all participating infants initially. During the follow-up, the PIP, MAP and FIO2 levels were significantly decreasing in the VTV group during the first 48 hrs. Moreover, The VTV group showed significantly lower incidence of hypocarbia and non-permissible hypercarbia. The VTV group showed significantly shorter duration of ventilation. There was no statistical significant difference between both groups as regards IVH, air leaks BPD, PDA or nosocomial infection
Conclusion: The use of VTV achieves adequate gas exchange using lower MAP and with less variability in tidal volume reducing the risk of hypocarbia and non-permissible hypercarbia. The use of VTV also shortens the duration of ventilation in premature infants with respiratory distress