Comparison between intermittent mandatory ventilation and synchronized intermittent mandatory ventilation with pressure support in children.
OBJECTIVE
To compare intermittent mandatory ventilation (IMV) with synchronized intermittent mandatory ventilation plus pressure support (SIMV+PS) in terms of time on mechanical ventilation, duration of weaning and length of stay in a pediatric intensive care unit (PICU).


METHODS
This was a randomized clinical trial that enrolled children aged 28 days to 4 years who were admitted to a PICU between October of 2005 and June of 2007 and put on mechanical ventilation (MV) for more than 48 hours. These patients were allocated to one of two groups by drawing lots: IMV group (IMVG; n = 35) and SIMV+PS group (SIMVG; n = 35). Children were excluded if they had undergone tracheotomy or had chronic respiratory diseases. Data on oxygenation and ventilation were recorded at admission and at the start of weaning.


RESULTS
There were no statistical differences between the groups in terms of age, sex, indication for MV, PRISM score, Comfort scale, use of sedatives or ventilation and oxygenation parameters. The median time on MV was 5 days for both groups (p = 0.120). There were also no statistical differences between the two groups for duration of weaning [IMVG: 1 day (1-6) vs. SIMVG: 1 day (1-6); p = 0.262] or length of hospital stay [IMVG: 8 days (2-22) vs. SIMVG: 6 days (3-20); p = 0.113].


CONCLUSIONS
Among the children studied here, there was no statistically significant difference between IMV and SIMV+PS in terms of time on MV, duration of weaning or time spent in the PICU. ClinicalTrials.govID: NCT00549809.
Moraes
Marcos A de
MA
Departamento de Pediatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, SP, Brazil. mamoraes@fmb.unesp.br
Bonatto
Rossano C
RC
Carpi
Mário F
MF
Ricchetti
Sandra M Q
SM
Padovani
Carlos R
CR
Fioretto
José R
JR
D002675:Child, Preschool; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric; D007385:Intermittent Positive-Pressure Ventilation / Q000379:methods*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D013997:Time Factors; D015300:Ventilator Weaning / Q000706:statistics & numerical data