title: Volume-targeted ventilation and arterial carbon dioxide in neonates.
abstract: OBJECTIVE
  To review the arterial carbon dioxide tensions (PaCO(2)) in newborn infants ventilated using synchronized intermittent mandatory ventilation (SIMV) in volume guarantee mode (using the Dräger Babylog 8000+) with a unit policy targeting tidal volumes of approximately 4 mL/kg.
  
  
  METHODS
  Data on ventilator settings and arterial PaCO(2) levels were collected on all arterial blood gases (ABG; n = 288) from 50 neonates (<33 weeks gestational age) ventilated using the Dräger Babylog 8000+ ventilator (Dräger Medizintechnik GmbH, Lübeck, Germany) in SIMV plus volume guarantee mode. Data were analysed for all blood gases done on the entire cohort in the first 48 h of life and a subanalysis was done on the first gas for each infant (n = 38) ventilated using volume guarantee from admission to the nursery. The number of ABG showing severe hypocapnoea (PaCO(2) < 25 mmHg) and/or severe hypercapnoea (PaCO(2) > 65 mmHg) were determined.
  
  
  RESULTS
  The mean (SD) PaCO(2) during the first 48 h was 46.6 (9.0) mmHg. The mean (SD) PaCO(2) on the first blood gas of those infants commenced on volume guarantee from admission was 45.1 (12.5) mmHg. Severe hypo- or hypercapnoea occurred in 8% of infants at the time of their first blood gas measurement, and in <4% of blood gas measurements in the first 48 h.
  
  
  CONCLUSIONS
  Infants ventilated with volume guarantee ventilation targeting approximately 4 mL/kg (range: 2.9-5.1) have acceptable PaCO(2) levels at the first blood gas measurement and during the first 48 h of life; and avoid severe hypo- or hypercapnoea over 90% of the time.
authors.affiliation: Grantley Stable Neonatal Unit, Royal Women's Hospital, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Dawson
authors.forename: Mark William
authors.initials: MW
authors.lastname: Davies
mesh_terms: D001158:Arteries / Q000503:physiopathology; D001315:Australia; D001784:Blood Gas Analysis; D002245:Carbon Dioxide / Q000097:blood*; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000503:physiopathology; D016857:Hypocapnia / Q000097:blood / Q000503:physiopathology; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D012122:Ventilators, Mechanical
chemical_list: D002245:Carbon Dioxide