instrumental dead space mechanical ventilation

Randomized multicenter trial comparing synchronized and conventional intermittent mandatory ventilation in neonates. Pediatr Pulmonol 1996 22: 305–313.īernstein G, Mannino FL, Heldt GP, Callahan JD, Bull DH, Sola A et al.

Influence of different methods of synchronized mechanical ventilation on ventilation, gas exchange, patient effort and blood pressure fluctuations in premature neonates. Hummler H, Gerhardt T, Gonzalez A, Claure N, Everett R, Bancalari E. Instrumental dead space imposes a ventilatory burden during SIMV weaning in small preterm infants. When flow sensor dead space was reduced during SIMV weaning, gas exchange was maintained with lower minute ventilation. SIMV weaning elicited a compensatory rise in spontaneous ventilation.

Three infants did not tolerate SIMV weaning without while one infant did not tolerate weaning with reduced dead space. Transcutaneous CO 2 tension during SIMV weaning periods without and with reduced dead space did not differ from baseline, whereas total minute ventilation and tidal volume were lower during the SIMV weaning period with reduced dead space. Dead space was reduced by flushing the flow sensor with a continuous gas leak flow in the endotracheal tube connector. A 30-min baseline was obtained before each weaning period. Twelve preterm infants (gestational age 25☒ weeks, birth weight 705☑58 g, age: 31☑86 days, SIMV rate: 25☘ breaths min –1, peak inspiratory pressure 18☒ cm H 2O, positive end-expiratory pressure: 5☐.5 cm H 2O, pressure support: 9☓ cm H 2O, fraction of inspired oxygen: 34☖%) underwent two 2.5-h weaning periods during which SIMV rate was reduced twice by 5 breaths min –1 at 30-min intervals as tolerated, with and without reduction of flow sensor dead space, in random sequence. The objective of this study was to assess the effects of flow sensor dead space during synchronized intermittent mandatory ventilation (SIMV) weaning in preterm infants. A majority of the modalities of synchronized ventilation in preterm infants require the use of flow sensors that can increase dead space and may adversely affect ventilator weaning.

Instrumental dead space mechanical ventilation