Crossover trial comparing pressure support with synchronized intermittent mandatory ventilation.

OBJECTIVE

To compare pressure support ventilation (PSV) with volume guarantee (VG) to synchronized intermittent mandatory ventilation (SIMV) in infants with respiratory distress syndrome (RDS).

STUDY

DESIGN

A randomized, crossover study design was used. We enrolled 14 infants [BW (mean+/-SD) 2.5+/-0.7 kg, GA 34+/-2 weeks, age 49+/-26 hours]. Subjects received 4 hours of each mode of ventilation, with the first mode selected randomly. End expiratory volume (EEV) was measured during both ventilatory modes.

RESULTS

Minute ventilation was greater with PSV+VG than with SIMV (p=0.012). This occurred despite no difference in p(a)CO(2). Mean airway pressure was higher during PSV+VG (p=0.023). There was no difference in the arterial/alveolar oxygen tension (a/A) ratio or in the specific dynamic compliance (sCdyn).

CONCLUSION

Because of an increase in V(E) with PSV+VG, and no difference in the a/A ratio or sCdyn, we do not recommend the routine use of PSV+VG for this population.