Efficacy of volume target pressure control and synchronized intermittent mandatory ventilation in treating neonatal respiratory distress syndrome

Abstract

Objective To investigate the efficacy of volume target pressure control(VTPC) and synchronized intermittent mandatory ventilation (SIMV)in treating severe neonatal respiratory distress syndrome (NRDS). Methods Fifty-six admitted cases with severe NRDS hospitalized in Jiangmen Central Hospital from October 2012 to March 2015 were randomly divided into 2 groups: 28 cases in VTPC group were treated by VTPC and SIMV, and 28 cases in pressure control ventilation (PCV)group were treated by PCV and SIMV.There was no significant difference between 2 groups in terms of gender, gestational age, and birth weight (all P>0.05). Artery blood gas analysis was performed at 6 hours, 12 hours, 24 hours, and 48 hours respectively after ventilation.The following parameters were observed: the time of invasive mechanical ventilation, duration of oxygen therapy, mortality and the incidence rates of hypocapnia, pneumothorax, ventilator associated pneumonia (VAP), grade Ⅲ-Ⅳ periventricular intraventricular hemorrhage (PVH-IVH), periventricular leukomalacia (PVL)and bronchopulmonary dysplasia (BPD). Results No case in 2 groups withdrew from the test.There was no significant difference between 2 groups in terms of the first treatment time and total doses of poractant alfa injection (all P>0.05). The time of invasive mechanical ventilation in VTPC group[(71.75±9.82) h] was shorter than that in PVC group[(97.89±16.88) h] (t=7.083, P=0.000). Hypocapnia incidence of four blood gas analysis in VTPC group[(19.64±14.20)%] was lower than that in PCV group[(47.32±18.43)%] (t=6.294, P=0.000). Incidence rates of VAP and PVL in VTPC group were lower than those in PCV group (χ2=5.197, P=0.023; χ2=4.766, P=0.029). However, duration of oxygen therapy, mortality and the incidence rates of pneumothorax, Ⅲ-Ⅳ PVH-IVH and BPD were not significantly different between 2 groups (all P>0.05). Conclusion VTPC+ SIMV has a better efficacy than PCV+ SIMV in the treatment of NRDS. Key words: Mechanical ventilation; Respiratory distress syndrome; Treatment; Infant, premature