Improved oxygenation during synchronized intermittent mandatory ventilation in neonates with XXXX : a randomized, crossover study.

@entity1 @entity649 @entity26 @entity544
In a randomized, crossover study, we compared arterial partial pressure of @entity26 and of @entity544 between consecutive periods of conventional and synchronized intermittent mandatory ventilation (SIMV). We studied spontaneously breathing @entity1 with an endotracheal tube in place. The @entity1 were < 12 hours of age, had a diagnosis of @entity649 , and had an arterial/alveolar @entity26 ratio of < 0.25. The @entity1 had a mean birth weight of 1077 gm and gestational age of 28 weeks. The mean rate of asynchrony on intermittent mandatory ventilation (IMV) was 52% (range, 36% to 76%), and on SIMV was < 1%. @entity1 were randomly assigned to IMV or SIMV as their initial ventilator mode and underwent ventilation for four 15-minute periods, and crossed over to the alternate mode after each period. Ventilator settings and the fraction of inspired @entity26 were not changed between modes. At the end of each period, arterial blood gas measurements were obtained; 26 paired comparisons were made between modes. The mean arterial partial pressure of @entity26 was significantly higher during SIMV than during IMV (mean, 61.5 vs 53.3 mmHg; p < 0.01). The mean arterial partial pressure of @entity544 was slightly lower during SIMV than during IMV (mean, 42.7 vs 41.3 mm Hg; p < 0.05). The improvement in oxygenation demonstrated with SIMV may allow a reduction in ventilator pressure or @entity26 exposure in this group of @entity1 , who are at risk of having complications of ventilation.
