Neonatal Respiratory Failure Clinical Trial
Official title:
Randomised Trial Comparing Assist Control Ventilation to Pressure Support Ventilation During Weaning
During assist control ventilation and pressure support ventilation (PSV), the start of ventilator inflation is determined by the start of the infant's inspiratory effort. During PSV, termination of inflation is determined by the level of the infant's inspiratory flow. In a randomized trial, no significant differences were found between assist control and pressure support ventilation with regard to the duration of weaning, time to successful extubation, work of breathing, rate of asynchrony and level of respiratory muscle strength.
Objectives: To test the hypothesis that the duration of weaning would be shorter using
assist control ventilation (ACV) rather than pressure support ventilation (PSV). To
determine if any differences in the duration of weaning reflected differences in the work of
breathing, the rate of asynchrony or the level of respiratory muscle strength.
Patients and methods: Thirty-six infants, median gestational age 29 (range 24 to 39) weeks,
were randomized to weaning by either ACV or PSV. The duration of weaning was recorded. At
baseline (study entry), 24 hours after entering the study and immediately prior to
extubation, the work of breathing was assessed by measuring the transdiaphragmatic pressure
time product (PTPdi), thoracoabdominal asynchrony (TAA) was assessed using respiratory
inductance plethysmography and respiratory muscle strength measured by recording the maximal
inspiratory pressure produced during an airway occlusion during crying (Pimax). Immediately
prior to extubation, the level of active expiration was also assessed.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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