Abstract
The effect of random changes in inspiratory flow rate was evaluated in 15 infants with RDS on assisted ventilation with a time-cycled continual flow ventilator. Other ventilator parameters were not altered. Ten infants were on intermittent mandatory ventilation (IMV); five were controlled under curare paralysis. At a flow of 12 liters/minute delivered tidal volumes and peak tracheal pressures were higher in all but one infant and respiratory rates were increased in those breathing spontaneously. In spite of this, PaCO2 was elevated and VA decreased in 12 of 15 patients. No changes in cardiac output or right to left shunting were observed. The increase in VD at the higher inspiratory flow rate may be related to increased volume of the anatomic dead space due to over-distention of the proximal airway.
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