Ventilation settings in preterm neonates with ventilator-dependant, evolving bronchopulmonary dysplasia
The only guidance in the literature on which tidal volumes to use when ventilating babies with, or at high risk of, bronchopulmonary dysplasia (BPD) suggests using very large volume breaths of around 8–12 mL/kg and low rates (10–20 breaths per min) to achieve adequate gas exchange, whilst acknowledg...
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| Veröffentlicht in: | Early human development 2021-08, Vol.159, p.105417-105417, Article 105417 |
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| creator | O'Connor, Kristin L. Davies, Mark W. |
| description | The only guidance in the literature on which tidal volumes to use when ventilating babies with, or at high risk of, bronchopulmonary dysplasia (BPD) suggests using very large volume breaths of around 8–12 mL/kg and low rates (10–20 breaths per min) to achieve adequate gas exchange, whilst acknowledging there are no data to validate these strategies. The aim of this retrospective, observational, cohort study was to identify the mechanical ventilation settings that are used, and what carbon dioxide (CO2) levels were achieved, in neonates with ventilator-dependant evolving BPD.
This retrospective cohort study included neonates born |
| doi_str_mv | 10.1016/j.earlhumdev.2021.105417 |
| format | Article |
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This retrospective cohort study included neonates born <30 weeks GA admitted to the Grantley Stable Neonatal Unit between May 2014 and December 2018. Included ventilator-dependant neonates with evolving BPD ventilated on either or all days 28, 42 and 56 of life.
A total of 105 neonates were included, all were between 23 and 28.5 weeks GA. The median (IQR) GA was 25.1 (24.2–26.5) weeks and BW 708 (608–809) grams. Neonates who required conventional mechanical ventilation (CMV) at each of the three time-points had median tidal volumes ranging between 4.5 and 4.7 mL/kg, median ventilator rates of 35–50 and MAPs of 10–11 cmH2O. For those neonates requiring HFOV, median MAPs ranged from 14 to 18 cmH2O and tidal volumes from 1.4 to 2.2 mL/kg to achieve adequate ventilation and oxygenation.
Neonates with ventilator-dependant evolving BPD were ventilated either with CMV using tidal volumes of around 4–5 mL/kg, or HFOV using tidal volumes around 1–2 mL/kg, which achieves adequate ventilation and blood gas results.</description><identifier>ISSN: 0378-3782</identifier><identifier>EISSN: 1872-6232</identifier><identifier>DOI: 10.1016/j.earlhumdev.2021.105417</identifier><identifier>PMID: 34242909</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Bronchopulmonary dysplasia ; Preterm infants ; Ventilation strategies ; Ventilator-dependant</subject><ispartof>Early human development, 2021-08, Vol.159, p.105417-105417, Article 105417</ispartof><rights>2021</rights><rights>Crown Copyright © 2021. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c374t-127647376ce8acaa2c9cba291062bb7c7241148a614f5c6cbc831902b8fcd82c3</citedby><cites>FETCH-LOGICAL-c374t-127647376ce8acaa2c9cba291062bb7c7241148a614f5c6cbc831902b8fcd82c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.earlhumdev.2021.105417$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,778,782,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34242909$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O'Connor, Kristin L.</creatorcontrib><creatorcontrib>Davies, Mark W.</creatorcontrib><title>Ventilation settings in preterm neonates with ventilator-dependant, evolving bronchopulmonary dysplasia</title><title>Early human development</title><addtitle>Early Hum Dev</addtitle><description>The only guidance in the literature on which tidal volumes to use when ventilating babies with, or at high risk of, bronchopulmonary dysplasia (BPD) suggests using very large volume breaths of around 8–12 mL/kg and low rates (10–20 breaths per min) to achieve adequate gas exchange, whilst acknowledging there are no data to validate these strategies. The aim of this retrospective, observational, cohort study was to identify the mechanical ventilation settings that are used, and what carbon dioxide (CO2) levels were achieved, in neonates with ventilator-dependant evolving BPD.
This retrospective cohort study included neonates born <30 weeks GA admitted to the Grantley Stable Neonatal Unit between May 2014 and December 2018. Included ventilator-dependant neonates with evolving BPD ventilated on either or all days 28, 42 and 56 of life.
A total of 105 neonates were included, all were between 23 and 28.5 weeks GA. The median (IQR) GA was 25.1 (24.2–26.5) weeks and BW 708 (608–809) grams. Neonates who required conventional mechanical ventilation (CMV) at each of the three time-points had median tidal volumes ranging between 4.5 and 4.7 mL/kg, median ventilator rates of 35–50 and MAPs of 10–11 cmH2O. For those neonates requiring HFOV, median MAPs ranged from 14 to 18 cmH2O and tidal volumes from 1.4 to 2.2 mL/kg to achieve adequate ventilation and oxygenation.
Neonates with ventilator-dependant evolving BPD were ventilated either with CMV using tidal volumes of around 4–5 mL/kg, or HFOV using tidal volumes around 1–2 mL/kg, which achieves adequate ventilation and blood gas results.</description><subject>Bronchopulmonary dysplasia</subject><subject>Preterm infants</subject><subject>Ventilation strategies</subject><subject>Ventilator-dependant</subject><issn>0378-3782</issn><issn>1872-6232</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNqFkMuO1DAQRS0EYpqBX0BesiCNXXnYWcJoeEgjsQG2llOpnnYrsYPtBM3f41E3sGRhlWSdW4_DGJdiL4Xs3p32ZON0XOeRtj0IkOW7baR6wnZSK6g6qOEp24la6ao8uGIvUjoJIVrdi-fsqm6ggV70O3b_g3x2k80ueJ4oZ-fvE3eeL5EyxZl7Ct5mSvyXy0e-XegQq5EW8qP1-S2nLUxbCfIhBo_HsKzTXFLxgY8PaZlscvYle3awU6JXl3rNvn-8_Xbzubr7-unLzfu7CmvV5EqC6hpVqw5JW7QWsMfBQi9FB8OgUEEjZaNtJ5tDix0OqGvZCxj0AUcNWF-zN-e-Sww_V0rZzC4hTZMth6zJQNsK6KTqZUH1GcUYUop0MEt0c9naSGEeNZuT-afZPGo2Z80l-voyZR1mGv8G_3gtwIczQOXWzVE0CR15pNFFwmzG4P4_5TdoaJZw</recordid><startdate>202108</startdate><enddate>202108</enddate><creator>O'Connor, Kristin L.</creator><creator>Davies, Mark W.</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202108</creationdate><title>Ventilation settings in preterm neonates with ventilator-dependant, evolving bronchopulmonary dysplasia</title><author>O'Connor, Kristin L. ; Davies, Mark W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c374t-127647376ce8acaa2c9cba291062bb7c7241148a614f5c6cbc831902b8fcd82c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Bronchopulmonary dysplasia</topic><topic>Preterm infants</topic><topic>Ventilation strategies</topic><topic>Ventilator-dependant</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O'Connor, Kristin L.</creatorcontrib><creatorcontrib>Davies, Mark W.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Early human development</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O'Connor, Kristin L.</au><au>Davies, Mark W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ventilation settings in preterm neonates with ventilator-dependant, evolving bronchopulmonary dysplasia</atitle><jtitle>Early human development</jtitle><addtitle>Early Hum Dev</addtitle><date>2021-08</date><risdate>2021</risdate><volume>159</volume><spage>105417</spage><epage>105417</epage><pages>105417-105417</pages><artnum>105417</artnum><issn>0378-3782</issn><eissn>1872-6232</eissn><abstract>The only guidance in the literature on which tidal volumes to use when ventilating babies with, or at high risk of, bronchopulmonary dysplasia (BPD) suggests using very large volume breaths of around 8–12 mL/kg and low rates (10–20 breaths per min) to achieve adequate gas exchange, whilst acknowledging there are no data to validate these strategies. The aim of this retrospective, observational, cohort study was to identify the mechanical ventilation settings that are used, and what carbon dioxide (CO2) levels were achieved, in neonates with ventilator-dependant evolving BPD.
This retrospective cohort study included neonates born <30 weeks GA admitted to the Grantley Stable Neonatal Unit between May 2014 and December 2018. Included ventilator-dependant neonates with evolving BPD ventilated on either or all days 28, 42 and 56 of life.
A total of 105 neonates were included, all were between 23 and 28.5 weeks GA. The median (IQR) GA was 25.1 (24.2–26.5) weeks and BW 708 (608–809) grams. Neonates who required conventional mechanical ventilation (CMV) at each of the three time-points had median tidal volumes ranging between 4.5 and 4.7 mL/kg, median ventilator rates of 35–50 and MAPs of 10–11 cmH2O. For those neonates requiring HFOV, median MAPs ranged from 14 to 18 cmH2O and tidal volumes from 1.4 to 2.2 mL/kg to achieve adequate ventilation and oxygenation.
Neonates with ventilator-dependant evolving BPD were ventilated either with CMV using tidal volumes of around 4–5 mL/kg, or HFOV using tidal volumes around 1–2 mL/kg, which achieves adequate ventilation and blood gas results.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>34242909</pmid><doi>10.1016/j.earlhumdev.2021.105417</doi><tpages>1</tpages></addata></record> |
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| ispartof | Early human development, 2021-08, Vol.159, p.105417-105417, Article 105417 |
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| language | eng |
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| source | Elsevier ScienceDirect Journals |
| subjects | Bronchopulmonary dysplasia Preterm infants Ventilation strategies Ventilator-dependant |
| title | Ventilation settings in preterm neonates with ventilator-dependant, evolving bronchopulmonary dysplasia |
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