RESUMO
Objective To explore the effect and complication of synchronized intermittent mandatory ventilation (SIMV) combined with pressure support ventilation (PSV) and targeted tidal volume (TTV) in treatment of neonatal respiratory distress syndrome(NRDS).Methods Fifty-three neonates with severe NRDS between Jan.2010 and Dec.2012 were randomly assigned to 2 groups according to the ventilation mode:SIMV + PSV + TTV group (n =27),and assist/control group (A/C group) (n =26).The oxygenation status,the durations of oxygen exposure and ventilation and the incidence of complications were observed.Results The oxygenation status arterial oxygen partial pressure/fraction of inspired oxygen (P/F),arterial oxygen partial pressure/alveolar O2 tension(a/APO2) in the SIMV + PSV +TTV group were significantly improved at 6 h after ventilation (t =9.393,4.856,all P ＜ 0.05) ;and compared with A/ C group,they were significantly improved at 6 h (t =6.132,2.805,all P ＜ 0.05),24 h (t =2.890,2.682,all P ＜0.05),72 h (t =3.804,4.053,all P ＜ 0.05) after ventilation in the SIMV + PSV + TTV group.The incidences of air leak syndrome and ventilation-associated pneumonia(VAP) were lower in the SIMV + PSV + TTV group than those in the A/C group(t =3.908,4.178,all P ＜ 0.05).There were no significant differences in the mortality between the two groups (t =0.534,P ＞ 0.05).Conclusions Compared with A/C,SIMV + PSV + TTV can improve the oxygenation status more quickly,and decrease the incidences of air leak syndrome and VAP in neonates with severe RDS.