Abstract
In a randomised trial, patient triggered (PTV) compared to conventional mechanical ventilation (CMV) was associated with a shorter duration of weaning in premature infants. During PTV, all the spontaneous breaths of the infant are supported by the ventilator and the work of breathing compared to the work of breathing during CMV could be reduced. To test that hypothesis we compared the diaphragmatic pressure-time product (PTPdi), the integration of transdiaphragmatic pressure over time, which reflects the energy expenditure of the diaphragm, in preterm infants supported by PTV and CMV. Twelve infants (median gestational age 27.5 weeks) were studied in the recovery stage of their respiratory illness. All infants were receiving caffeine. The infants were studied both on PTV and CMV in a random order, each for 5 minutes. Transdiaphragmatic pressure (Pdi) was calculated by subtraction of oesophageal from gastric pressure measured using a dual tip pressure catheter. The inspiratory duty cycle was calculated from the airflow signal measured using a pneumotachograph inserted into the distal end of the endotracheal tube. The mean PTPdi per breath cycle expressed over one minute was calculated during the last minute of each five minute period. The PTPdi on CMV was significantly higher than the PTPdi on PTV (median 197.5 cmH2O*sec/min, range 117.9–321.4, versus median 95.6 cmH2O*sec/min, range 51.9–270.9, respectively, p=0.0022). In conclusion, the diaphragmatic workload is higher on CMV than on PTV and this may explain the superiority of PTV as a weaning ventilatory mode.
Article PDF
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Dimitriou, G., Kortsalioudaki, C., Giliberti, P. et al. 96 Comparison of the Respiratory Workload During Patient Triggered and Conventional Mechanical Ventilation Modes in Premature Infants (UK). Pediatr Res 58, 371 (2005). https://doi.org/10.1203/00006450-200508000-00125
Issue Date:
DOI: https://doi.org/10.1203/00006450-200508000-00125