Abstract
Background and Aims: Hypocarbia in preterm infants affects neurodevelopmental outcome. We showed by repeated audit that preterm ventilated infants were routinely running low CO2 (< 4.5) (25% in 2008), despite educational interventions. We therefore added volume limitation to our normal pressure controlled ventilation in 2010. We evaluated the impact by auditing blood gas values.
Methods: Audit of blood gas CO2 levels of preterm ventilated infants managed with volume limitation in comparison to previous audit data from before this change.
Results: 19 infants contributed 109 gases during their first 24 hours of life. 6% of these had a pCO2 < 4.5 in comparison to 25% from the previous cohort. There was no increase in very high levels of pCO2 (defined as >7.5).
Conclusions: Volume limitation successfully reduced the number of blood gases with very low levels of pCO2 where education had failed. This was achieved without any increase in gases with a high pCO2. This method has been easily understood by a team experienced only in pressure limited ventilation. Other units that currently pressure ventilate may like to consider this method of helping to achieve targeted CO2 values without the need to switch to volume ventilation.
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Berrington, J., Summers, D. & Van Ruiten, H. Volume Limitation Reduces Early Significant Hypocarbia in Preterm Ventilated Infants in a Busy Tertiary Neonatal Setting. Pediatr Res 70 (Suppl 5), 619 (2011). https://doi.org/10.1038/pr.2011.844
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DOI: https://doi.org/10.1038/pr.2011.844