Hyaline membrane disease. A controlled study of inspiratory to expiratory ratio in its management by ventilator.
Sixty-nine neonates with severe hyaline membrane disease (HMD) were mechanically ventilated using either a 1:2 or a 2:1 inspiratory to expiratory (I/E) ratio. Survivors in the 2:1 group required a lower fraction of oxygen in the inspired air (FiO2) and lower end-expiratory pressure to achieve satisfactory oxygenation. During the first week of life, time of exposure to FiO2 greater than 0.60 while being mechanically ventilated was 29.7 +/- 7.5 hours for the 1:2 group and 6.6 +/- 2,7 hours for the 2:1 group, while time of exposure to end-expiratory pressure greater than 3 cm H2O was 49.4 +/- 7.9 hours for the 1:2 group and 13.4 +/- 7.4 hours for the 2:1 group. Mortality and the incidence of air leak, patent ductus arteriosus, intraventricular hemorrhage, necrotizing enterocolitis, bronchopulmonary dysplasia, and pulmonary hemorrhage were not different for the two groups. Using an increased I/E ratio during the acute phase of HMD improved oxygenation but did not alter morbidity or mortality.
D002245:Carbon Dioxide / Q000097:blood; D006801:Humans; D006819:Hyaline Membrane Disease / Q000097:blood / Q000401:mortality / Q000628:therapy*; D007231:Infant, Newborn; D010100:Oxygen / Q000097:blood; D010313:Partial Pressure; D011446:Prospective Studies; D012123:Pulmonary Ventilation; D012121:Respiration, Artificial
D002245:Carbon Dioxide; D010100:Oxygen