RANDOMIZED TRIAL OF VOLUME CONTROLLED VERSUS TIME CYCLED, PRESSURE LIMITED VENTILATION IN PRETERM INFANTS WITH RESPIRATORY-DISTRESS SYNDROME

Fifty preterm infants weighing 1200 g or more with clinical and radiog raphic evidence of respiratory distress syndrome, requiring both mecha nical ventilation and exogenous surfactant replacement, were randomly allocated to receive either volume controlled ventilation or time cycl ed, pressure limited ventilation, Tidal volume delivery in each group was deliberately controlled at 5-8 ml/kg so thar the only difference b etween the two groups uas the ventilatory modality, the manner in whic h tidal volume was delivered. The rest of the ventilatory management a nd clinical care was done according to protocol. The two modes of vent ilation were compared by determining the time required to achieve pre- determined success criteria, based on either the alveolar-arterial oxy gen gradient or the mean airway pressure as a standard against which t he speed of weaning could be objectively assessed, Infants randomised to volume controlled ventilation met success criteria sooner and had a shorter duration of mechanical ventilation. These babies also had a s ignificantly lower incidence of intraventricular haemorrhages and abno rmal periventricular echodensities on ultrasound scans, Volume control led ventilation seems to be both safe and effective in this group of p atients.