Neonatal and Adult ICU Ventilators to Provide Ventilation in Neonates, Infants, and Children: A Bench Model Study

Ventilatory Support in Children With Pediatric Acute Respiratory Distress Syndrome

“…Although trigger and cycling systems have technically been brought to high performance, especially for mechanical ventilators designed for the neonatal and/or pediatric patient population (2), there is no solid published experience in the pediatric population documenting that breath synchronization improves outcome (i.e., time on mechanical ventilation, duration of weaning, time spent in the PICU, or mortality) in patients with respiratory failure (3,4). Similarly, in the neonatal setting, patient-ventilator synchronization has not shown improvement in outcome or long-term efficacy when compared with nonsynchronized ventilation (5).…”

“…2 We recommend to use patient-specific tidal volumes according to disease severity. Weak agreement (88% agreement) 3.2.…”

Neonatal Pressure Support Ventilation: Are We Doing What We Think We Are Doing?

“…The data presented by Vignaux et al 9 suggest that in some cases we are and in some cases we are not. The variability in ventilator performance reported here is consistent with previous reports on other ventilator characteristics, lending weight to their findings.…”

“…In this issue of RESPIRATORY CARE, Vignaux et al 9 attempt to improve our understanding of pressure support breathing in a variety of adult and neonatal ventilators using an ingenious bench model designed to simulate the specific characteristics of neonates and infants that make ventilation particularly challenging. Specifically, they tested 6 adult and 4 neonatal ventilators in 3 patient scenarios: a preterm infant with relatively high resistance, low compliance, and low inspiratory effort; a full-term infant with moderate resistance, moderate compliance, and higher inspiratory effort; and a child with lower resistance, higher compliance, and substantially higher inspiratory effort.…”

Effects of Leak Compensation on Patient-Ventilator Synchrony During Premature/Neonatal Invasive and Noninvasive Ventilation: A Lung Model Study

“…9,10 However, to the best of our knowledge, there have been no assessments of leak compensation during premature/neonatal ventilation using a digital lung simulator. Recently, Vignaux et al 11 performed a neonatal lung model study that compared the abilities of 4 neonatal and 6 adult ventilators to trigger, pressurize, and cycle in both the absence and presence of leaks during invasive ventilation and NIV. The focus of these comparisons was more on ventilation performance than leak compensation, and the leak compensation algorithm was activated only during NIV.…”