Journal of perinatology : official journal of the California Perinatal Association
-
Randomized Controlled Trial Comparative Study
Effect of volume guarantee combined with assist/control vs synchronized intermittent mandatory ventilation.
To compare the effect of combining assist/control with volume-guarantee (AC+VG) vs synchronized intermittent mandatory ventilation with VG (SIMV+VG) on tidal volume (V(T)), peak inspiratory pressure (PIP), mean airway pressure (MAP), respiratory rate, heart rate, oxygen saturation (SpO(2)), and minute volume (MV) in preterm infants. ⋯ SIMV+VG is associated with higher work of breathing indicated by tachycardia, tachypnea and lower SpO(2) compared to AC+VG. VG appears to be more effective when combined with AC than with SIMV.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Work of breathing during nasal continuous positive airway pressure in preterm infants: a comparison of bubble vs variable-flow devices.
To compare work of breathing and breathing asynchrony during bubble nasal continuous positive airway pressure (NCPAP) vs variable-flow (VF)-NCPAP in premature infants. ⋯ The more labored and asynchronous breathing seen with bubble NCPAP may lead to higher failure rates over the long term than with VF-NCPAP.
-
Randomized Controlled Trial Clinical Trial
Effects of pressure support during an acute reduction of synchronized intermittent mandatory ventilation in preterm infants.
During weaning of synchronized intermittent mandatory rate in preterm infants, the spontaneous breaths must overcome the resistance of the endotracheal tube and the disease-induced respiratory loads. Pressure Support (PS) can be used as an adjunct to synchronized intermittent mandatory ventilation (SIMV) to partially unload the spontaneous breaths. ⋯ Assistance of the spontaneous breaths with pressure support maintained gas exchange. PS of 6 cm H(2)O prevented an increase in breathing effort during an acute 50% reduction in SIMV rate.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Heat loss prevention for preterm infants in the delivery room.
Preterm infants are prone to hypothermia immediately following birth. Among other factors, excessive evaporative heat loss and the relatively cool ambient temperature of the delivery room may be important contributors. Most infants <29 weeks gestation had temperatures <36.4 degrees C on admission to our neonatal unit (NICU). Therefore we conducted a randomized, controlled trial to evaluate the effect of placing these infants in polyurethane bags in the delivery room to prevent heat loss and reduce the occurrence of hypothermia on admission to the NICU. ⋯ Placing infants <29 weeks gestation in polyurethane bags in the delivery room reduced the occurrence of hypothermia and increased their NICU admission temperatures. Maintaining warmer delivery rooms helped but was insufficient in preventing hypothermia in most of these vulnerable patients without the adjunctive use of the polyurethane bags.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Is there an advantage of using pressure support ventilation with volume guarantee in the initial management of premature infants with respiratory distress syndrome? A pilot study.
To evaluate the feasibility of using the pressure support ventilation with volume guarantee (PSV-VG) as an initial ventilatory mode in preterm infants with respiratory distress syndrome (RDS) after surfactant treatment to achieve accelerated weaning of peak inspiratory pressure (PIP) and mean airway pressure (MAP). ⋯ PSV-VG did not offer any ventilatory advantage over SIMV in the initial management of surfactant-treated premature newborns with RDS except for minimizing the number of blood gases.