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Title Computer-controlled minute ventilation in preterm infants undergoing mechanical ventilation
Author(s) Nelson Claure; Tilo Gerhardt; Helmut Hummler; Ruth Everett; Eduardo Bancalari
Source J. Peds, Vol. 131, No. 6, Pages 910-913
Publication Date Dec. 1997
Abstract Introduction: Computer-controlled minute ventilation (CCMV) continuously adjusts the ventilator rate to changes in spontaneous respiratory drive and pulmonary mechanics to maintain a prset total minute ventilation.

Hypothesis: We hypothesized that CCMV would maintain ventilatoin and oxygenation with fewer mechanical breaths than conventional intermittent mandatory ventilation in very low birth weight infants.

Methods: Very low birth weight infants in clinical stable condition who were undergoing mechanical ventilation were enrolled. The number of mechanical breaths, total and mechanical expiratory minute ventilation, mean airway pressure, oxygen hemoglobin saturation by pulse oximetry, and transcutaneous partial carbon dioxide and partial oxygen tensions were obtained during intermittent mandatory ventilation and CCMV (45 to 60 minutes) and compared by paired t test.

Results: Fifteen infants were studied. Birth weight (median, range) was 700 gm (550 to 1205 gm), gestational age 26 weeks (23 to 34 weeks), age 21 days (3 to 50 days). When switched from intermittent mandatory ventilation to CCMV, the number of mechanical breaths was reduced (15 +/- 2.8 to 8.6 +/- 2.9 breaths per minute, p < 0.001), leading to lower airway pressure (3.97 +/- 1.00 to 3.45 +/- 1.00 H2O, p < 0.001) and lower expiratory minute ventilation generated by the mechanical ventilator (116 +/- 31 to 65 +/- 28 ml/min per kilogram, p < 0.001), while total expiratory minute ventilation remained unchanged. Mean transcutaneous partial carbon dioxide and oxygen tensions, oxygen hemoglobin concentration, and the time spent within different oxygen hemoglobin saturation ranges did not differ between both ventilatory modes.

Conclusion: CCMV maintained adequate ventilation and oxygenation with lower mechanical ventilatory support than IMV. CCMV may reduce barotrauma and chronic lung disease during long-term use.


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