A Randomized Trial of Volume-Controlled vs. Time-Cycled, Pressure-Limited Ventilation in Preterm Infants with Respiratory Distress Syndrome. † 1592

Fifty preterm infants weighing ≥1200 g at birth with Respiratory Distress Syndrome requiring mechanical ventilation and surfactant therapy and having a compatible chest radiograph were randomly assigned to receive either volume-controlled (VC) or time-cycled, pressure-limited (TCPL) ventilation. Tidal volume was controlled at 5-8 mL/kg in each group, and weaning from mechanical ventilation was done per protocol.. The primary outcome measure was the time to achieve pre-determined success criteria of an AaDO2 ≤100 torr, or a Paw ≤8.0 cm H2O, or extubation if it occurred first.Table

Table 1

Patients treated with VC reached success criteria 40% faster and had a statistically significant reduction in neuroimaging abnormalities as well as a strong trend to less chronic lung disease than infants treated with TCPL. We conclude that in this population VC is safe and efficacious and may offer some advantages over TCPL.