title: Crossover trial comparing pressure support with synchronized intermittent mandatory ventilation.
abstract: OBJECTIVE
  To compare pressure support ventilation (PSV) with volume guarantee (VG) to synchronized intermittent mandatory ventilation (SIMV) in infants with respiratory distress syndrome (RDS).
  
  
  METHODS
  A randomized, crossover study design was used. We enrolled 14 infants [BW (mean+/-SD) 2.5+/-0.7 kg, GA 34+/-2 weeks, age 49+/-26 hours]. Subjects received 4 hours of each mode of ventilation, with the first mode selected randomly. End expiratory volume (EEV) was measured during both ventilatory modes.
  
  
  RESULTS
  Minute ventilation was greater with PSV+VG than with SIMV (p=0.012). This occurred despite no difference in p(a)CO(2). Mean airway pressure was higher during PSV+VG (p=0.023). There was no difference in the arterial/alveolar oxygen tension (a/A) ratio or in the specific dynamic compliance (sCdyn).
  
  
  CONCLUSIONS
  Because of an increase in V(E) with PSV+VG, and no difference in the a/A ratio or sCdyn, we do not recommend the routine use of PSV+VG for this population.
authors.affiliation: Department of Pediatrics, Section of Neonatology, Children's Mercy Hospitals and Clinics, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64108, USA.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Olsen
authors.forename: Donald W
authors.initials: DW
authors.lastname: Thibeault
authors.forename: William E
authors.initials: WE
authors.lastname: Truog
mesh_terms: D002245:Carbon Dioxide / Q000097:blood; D018592:Cross-Over Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007385:Intermittent Positive-Pressure Ventilation / Q000379:methods*; D008297:Male; D011336:Probability; D011659:Pulmonary Gas Exchange; D012016:Reference Values; D012127:Respiratory Distress Syndrome, Newborn / Q000175:diagnosis / Q000628:therapy*; D012129:Respiratory Function Tests; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide