Effects of hypocarbia on the development of cystic periventricular leukomalacia in premature infants treated with high-frequency jet ventilation. Wiswell TE, Graziani LJ, Kornhauser MS, et al. Hypocarbia and cystic periventricular leukomalacia in premature infants. Pediatrics 1992 90:515–522.įujimoto S, Togari H, Yamaguchi N, Mizutani F, Suzuki S, Sobajima H. Neurosonographic and developmental studies. Mechanical ventilation in preterm infants. Graziani LJ, Spitzer AR, Mitchell DG, et al. Lung protective strategies of ventilation in the neonate: what are they? Pediatrics 2000 105 (1):112–114. Am J Respir Crit Care Med 1998 157:294–323.Ĭlark RH, Slutsky AS, Gertsmann DR. Ventilator-induced lung injury: lessons from experimental studies. It remains to be seen if these short-term benefits will translate into shorter duration of ventilation or reduced incidence of chronic lung disease.ĭreyfuss D, Saumon G. More consistent tidal volume, fewer excessively large breaths, lower peak pressure, less hypocarbia and lower levels of inflammatory cytokines have been documented. The Volume Guarantee mode has been studied most thoroughly and is the only one that provides automatic weaning of peak pressure in response to improving lung compliance and patient respiratory effort. Each of the modes has advantages and disadvantages, with limited clinical data available to judge their effectiveness. Recently, microprocessor-based modifications of pressure-limited, time-cycled ventilators were developed to combine advantages of pressure-limited ventilation with the ability to deliver a more consistent tidal volume. Recognition that volume, not pressure, is the key factor in ventilator-induced lung injury and awareness of the association of hypocarbia and brain injury foster the desire to better control delivered tidal volume.
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