Polglase, GR and Tingay, DG and Bhatia, R and Berry, CA and Kopotic, RJ and Kopotic, CP and Song, Y and Szyld, E and Jobe, AH and Pillow, JJ, Pressure- versus volume-limited sustained inflations at resuscitation of premature newborn lambs, BMC Paediatrics, 14 Article 43. ISSN 1471-2431 (2014) [Refereed Article]
© 2014 Polglase et al.; licensee BioMed Central Ltd. Licensed under Creative Commons Attribution 2.0 Generic (CC BY 2.0) https://creativecommons.org/licenses/by/2.0/
Methods: 131 d gestation lambs were resuscitated with either: i) pressure-limited SI (PressSI: 0-40 cmH2O over 5 s, maintained until 20 s); or ii) volume-limited SI (VolSI: 0-15 mL/kg over 5 s, maintained until 20 s). Following the SI, all lambs were ventilated using volume-controlled ventilation (7 mL/kg tidal volume) for 15 min. Lung mechanics, regional ventilation distribution (electrical impedance tomography), cerebral tissue oxygenation index (near infrared spectroscopy), arterial pressures and blood gas values were recorded regularly. Pressure-volume curves were performed in-situ post-mortem and early markers of lung injury were assessed.
Results: Compared to a pressure-limited SI, a volume-limited SI had increased pressure variability but reduced volume variability. Each SI strategy achieved similar end-inflation lung volumes and regional ventilation homogeneity. Volume-limited SI increased heart-rate and arterial pressure faster than pressure-limited SI lambs, but no differences were observed after 30 s. Volume-limited SI had increased arterial-alveolar oxygen difference due to higher FiO2 at 15 min (p = 0.01 and p = 0.02 respectively). No other inter-group differences in arterial or cerebral oxygenation, blood pressures or early markers of lung injury were evident.
Conclusion: With the exception of inferior oxygenation, a sustained inflation targeting delivery to preterm lambs of 15 mL/kg volume by 5 s did not influence physiological variables or early markers of lung inflammation and injury at 15 min compared to a standard pressure-limited sustained inflation.
|Item Type:||Refereed Article|
|Keywords:||mechanical ventilation, infant, newborn, lung recruitment, ventilation homogeneity, variability|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Respiratory diseases|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Song, Y (Dr Yong Song)|
|Web of Science® Times Cited:||25|
|Deposited By:||Menzies Institute for Medical Research|
|Downloads:||10 View Download Statistics|
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