Comparison of Different Rates of Artificial Ventilation in Preterm Neonates with Respiratory Distress Syndrome

Abstract

The effectiveness of three different ventilator rates of artificial ventilation (30, 60 and 120/min) was studied in 32 preterm infants, all of whom were suffering from the Respiratory Distress Syndrome (16 were paralysed). Ventilator pressures, I:E ratio and MAP were kept constant at each rate. Increase in rate from 30 to 60 and to 120/min was well tolerated and not associated with episodes of hypotension. The only significant improvement in oxygenation was amongst the non-paralysed infants and at a rate of 120/min (p less than 0.01) this was associated with synchronous respiration. Two different ventilators were used in the study and a significant change in PaCO2 (reduction) occurred only in non-paralysed infants ventilated at a rate of 120/min by Sechrist ventilators (p less than 0.05). This difference may be a direct reflection of differences in ventilator performance at fast rates.

Application of Mid-Frequency Ventilation in an Animal Model of Lung Injury: A Pilot Study

“…More importantly, our data are in keeping with data generated from neonatal studies in which conventional ventilation applied at higher breathing frequencies with pressure control ventilation (similar to MFV) led to improved ventilation outcomes. 23,24 Our study demonstrated an increase in heart rate during the application of MFV, which, although not statistically significant, raises the concern for a decrease in stroke volume. Given the lower central venous pressure, stable airway, and pulmonary pressures, we suspect the cause was hypovolemia (decreasing central venous pressure through the study).…”

Neonatal complications of extreme prematurity in mechanically ventilated infants

“…It is tempting to speculate that this reduction in the occurrence of air leak is due to the introduction of fast rate ventilation, to promote synchrony [8][9][10] used in association with selective paralysis of only those infants who fail to synchronize despite increase of the ventilator rate.…”

Ventilator settings for newborn infants.

“…Recently, we have successfully answered the question of which ventilator rate is most beneficial in such a homogeneous group of infants-those with pneumonia, apnoea, and pulmonary hypoplasia; we excluded those with meconium aspiration. 2 We found that fast rates (greater than 100/minute) were associated with a significant increase in both oxygenation and carbon dioxide removal when compared to slower rates. The explanation for this was (as we subsequently showed3) that at such rates infants breathe in synchrony with their ventilator.…”