title: How to ventilate term babies.
abstract: Infants born at term frequently require mechanical ventilation and suffer significant mortality and morbidity. Yet, there have been few randomised trials (RCTs) exclusively of term born infants and when term born infants have been included in studies, a sub-analysis of their results has rarely been undertaken. The limited evidence demonstrates in term born infants that there are no benefits in using rates >60bpm during conventional mechanical ventilation (CMV) or using synchronous intermittent mandatory ventilation. Pressure support ventilation may reduce their work of breathing (WOB). During volume targeted ventilation, a volume targeted (VT) level of 6mls/kg reduces the WOB compared to a lower level or no VT. High frequency oscillatory ventilation in infants born at or near term with severe respiratory failure does not reduce mortality, oxygen dependency at 28 days or intracranial haemorrhage. RCTs with long term outcome are required to determine the optimum ventilatory modes in term born infants.
authors.affiliation: Division of Asthma Allergy and Lung Biology, MRC & Asthma UK Centre in Allergic, Mechanisms of Asthma, King's College London, London SE5 9RS, United Kingdom. anne.greenough@kcl.ac.uk
authors.forename: Anne
authors.initials: A
authors.lastname: Greenough
authors.forename: Prashanth
authors.initials: P
authors.lastname: Bhat
mesh_terms: D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy; D012121:Respiration, Artificial / Q000379:methods* / Q000592:standards; D012131:Respiratory Insufficiency / Q000628:therapy; D006113:United Kingdom; D014939:Work of Breathing