Influence of low volume-pressure limited ventilation on outcome of severe paediatric pulmonary diseases

Citation
G. Briassoulis et al., Influence of low volume-pressure limited ventilation on outcome of severe paediatric pulmonary diseases, MIN INVAS T, 8(5), 1999, pp. 377-384
Citations number
34
Categorie Soggetti
Surgery
Journal title
MINIMALLY INVASIVE THERAPY & ALLIED TECHNOLOGIES
ISSN journal
13645706 → ACNP
Volume
8
Issue
5
Year of publication
1999
Pages
377 - 384
Database
ISI
SICI code
1364-5706(199910)8:5<377:IOLVLV>2.0.ZU;2-Q
Abstract
To examine the influence of low volume-pressure limited ventilation (LVPLV) on mortality and mechanical ventilation (MV)-induced lung injury we report on a retrospective, cohort study done in a paediatric intensive care unit (PICU) in a tertiary care children's hospital. Patients studied were a cons ecutive series of 100 critically-ill children, receiving MV for severe resp iratory diseases between 1985 and 1996. LVPLV strategies were used during t he last 6 years (1991-96), compared with conventional ventilatory support u sed during the previous 6 year period (1985-90). Comparison of data between the two periods of the study showed that the survival rate increased from 57% to 84% (p < 0.003), whereas the air-leak frequency declined significant ly (27% versus 8%, p < 0.02). These changes were preceded by a significant reduction in the maximum tidal volumes (V-T 12.1 versus 8.97 ml.kg(-1), p = 0.001), corresponding to higher longitudinal maximum PaCO2 values (59.4 ve rsus 68 mmHg, p = 0.003). These results indicate that LVPLV, adjusted to de liver a lower level of ventilatory support by simple modifications of basic mechanical ventilation modalities, might have the potential to improve the outcome of children with severe parenchymal lung diseases.