Randomized controlled study of targeted tidal volume ventilation for treatment of severe neonatal respiratory distress syndrome / 中国当代儿科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the efficacy of targeted tidal volume ventilation in the treatment of severe neonatal respiratory distress syndrome (RDS).</p><p><b>METHODS</b>Eighty-four neonates with severe RDS between June 2008 and January 2010 were randomly assigned to 3 groups according to the ventilation mode synchronized intermittent positive pressure ventilation plus volume guarantee (SIPPV+VG; n=31), high frequency oscillation ventilation (HFOV; n=23) and intermittent mandatory ventilation (IMV; n=30). The oxygenation status, the durations of oxygen exposure and ventilation and the incidence of complications were observed.</p><p><b>RESULTS</b>The oxygenation status (P/F and a/APO2) in the SIPPV+VG and the HFOV groups was improved significantly 12 hrs after ventilation (P<0.05). While in the IMV group, the oxygenation status was not improved until 24 hrs after ventilation. The durations of oxygen exposure and ventilation in the SIPPV+VG and the HFOV groups were shorter than in the IMV group (P<0.05). The incidences of air leak syndrome and ventilation-associated pneumonia (VAP) were lower in the SIPPV+VG and the HFOV groups than in the IMV group (P<0.05). The incidence of severe intracranial hemorrhage in the HFOV group was higher than in the other two groups (P<0.05).</p><p><b>CONCLUSIONS</b>Compared with IMV, SIPPV+VG and HFOV can improve the oxygenation status more quickly, shorten the ventilation duration and decrease the incidences of air leak syndrome and VAP in neonates with severe RDS.</p>