Singh Jaideep, Sinha Sunil K, Clarke Paul, Byrne Steve, Donn Steven M
Paediatrics and Neonatal Medicine, University of Durham and James Cook University Hospital, Marton Road, Middlesbrough, United Kingdom.
J Pediatr. 2006 Sep;149(3):308-13. doi: 10.1016/j.jpeds.2006.01.044.
To compare the efficacy and safety of volume-controlled (VC) ventilation to time-cycled pressure-limited (TCPL) ventilation in very low birth weight infants with respiratory distress syndrome (RDS).
Newborns weighing between 600 and 1500 g and with a gestational age of 24 to 31 weeks who had RDS were randomized to receive either VC or TCPL ventilation and treated with a standardized protocol. The 2 modalities were compared by determining the time required to achieve a predetermined success criterion, on the basis of either the alveolar-arterial oxygen gradient <100 mm Hg or the mean airway pressure <8 cm H(2)O. Secondary outcomes included mortality, duration of mechanical ventilation, and complications commonly associated with ventilation.
The mean time to reach the success criterion was 23 hours in the VC group versus 33 hours in the TCPL group (P = .15). This difference was more striking in babies weighing <1000g (21 versus 58 hours; P = .03). Mean duration of ventilation with VC was 255 hours versus 327 hours with TCPL (P = .60). There were 5 deaths in the VC group and 10 deaths in the TCPL group (P = .10). The incidence of other complications was similar.
VC ventilation is safe and efficacious in very low birth weight infants and may have advantages when compared with TCPL, especially in smaller infants.
比较容量控制（VC）通气与时间切换压力限制（TCPL）通气在极低出生体重儿呼吸窘迫综合征（RDS）中的疗效和安全性。
将体重600至1500克、胎龄24至31周且患有RDS的新生儿随机分为接受VC或TCPL通气，并按照标准化方案进行治疗。根据肺泡-动脉氧分压差<100 mmHg或平均气道压<8 cm H₂O来确定达到预定成功标准所需的时间，以此对两种通气方式进行比较。次要结局包括死亡率、机械通气持续时间以及与通气相关的常见并发症。
VC组达到成功标准的平均时间为23小时，而TCPL组为33小时（P = 0.15）。这种差异在体重<1000克的婴儿中更为显著（21小时对58小时；P = 0.03）。VC通气的平均持续时间为255小时，而TCPL为327小时（P = 0.60）。VC组有5例死亡，TCPL组有10例死亡（P = 0.10）。其他并发症的发生率相似。
VC通气在极低出生体重儿中安全有效，与TCPL相比可能具有优势，尤其是在较小的婴儿中。
