Abstract 22

Background It has been suggested that synchronising the ventilator rate with the baby's own respiratory rate will reduce the complications of mechanical ventilation. Trigger ventilation is one means of doing this. There is no published direct comparison between conventional and trigger ventilation with respect to acute and long term outcomes. We aimed therefore to perform a randomised trial comparing patient trigger ventilation with conventional (fast rate) ventilation in preterm infants ventilated for RDS. The primary outcome measure was oxygen dependency at 28 days.

Subjects Three hundred and eighty-six infants with a birthweight between 1000 to 2000 grams was randomised to receive either conventional or trigger ventilation with an SLE 2000 ventilator within 24 hours of birth.

Results Between the conventional and trigger groups there was no significant difference respectively in the incidence of oxygen dependency at 28 days (31% vs 32%) or 36 weeks post menstrual age (29% vs 32%), death (4% vs 8%), death or oxygen dependency at 36 weeks (32% vs 37%) pneumothorax (11% vs 10%), grade 3 intraventricular haemorrhage (7% vs 4%), median ventilator days (4 vs 3) or median days of continuous oxygen therapy (5 vs 4).

Conclusions Patient trigger ventilation is a feasible mode of ventilating infants with RDS. It does not reduce short or long term respiratory morbidity or other complications.