title: Synchronous mechanical ventilation of the neonate with respiratory disease.
abstract: OBJECTIVE
  To assess the importance of synchronization of mechanical ventilation with spontaneous respiratory efforts in mechanically ventilated neonates. The actions of this synchronization on ventilation, oxygenation, and BP variation were assessed.
  
  
  METHODS
  Prospective evaluation using within-subject comparison of asynchronous and synchronous states.
  
  
  METHODS
  Neonatal ICU in a large, university-affiliated hospital.
  
  
  METHODS
  Fourteen neonates requiring mechanical ventilation who were initially asynchronous with the ventilator.
  
  
  METHODS
  The ventilator settings were adjusted using the patients' own inspiratory and expiratory timing to create synchronous interaction with the ventilator.
  
  
  RESULTS
  Synchrony was assessed using clinical observation combined with inspection of the air flow waveform and computerized analysis of the air flow signal to assess cycle-to-cycle reproducibility, so-called autocorrelation. Synchronous ventilation significantly improved tidal volume (p < .05), minute volume (p < .001), and all indices of the variability of arterial BP (p < .001). Mean airway pressure did not change significantly. No infant developed an airleak syndrome or intraventricular hemorrhage, which have previously been associated with asynchronous ventilation and an unstable BP, respectively.
  
  
  CONCLUSIONS
  Synchronous ventilation can be readily applied to most ventilated neonates. It improves ventilation, and results in a marked reduction in BP variation, which may have implications for reducing the risk of intraventricular hemorrhage.
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Canada.
authors.forename: M
authors.initials: M
authors.lastname: Amitay
authors.forename: P C
authors.initials: PC
authors.lastname: Etches
authors.forename: N N
authors.initials: NN
authors.lastname: Finer
authors.forename: J M
authors.initials: JM
authors.lastname: Maidens
mesh_terms: D001794:Blood Pressure; D002543:Cerebral Hemorrhage / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D011446:Prospective Studies; D012119:Respiration; D012121:Respiration, Artificial / Q000379:methods*; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000503:physiopathology* / Q000628:therapy*