title: Volume-targeted ventilation is more suitable than pressure-limited ventilation for preterm infants: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess the effect of volume-targeted ventilation (VTV) compared with pressure-limited ventilation (PLV) in preterm infants.
  
  
  METHODS
  We searched the Cochrane Library (Issue 3, 2013), PubMed (1966 to 5 March 2013), China National Knowledge Infrastructure (CNKI) and periodical databases (1979 to 5 March 2013). We selected randomised controlled trials (RCTs) and quasi-RCTs of VTV versus PLV as active interventions in preterm infants. We performed meta-analyses using the Cochrane statistical package RevMan 5.0.
  
  
  RESULTS
  Eighteen trials met our inclusion criteria. There was no evidence that VTV modes reduced the incidence of death (relative risk (RR) 0.73, 95% CI 0.51 to 1.05). The use of VTV modes resulted in a reduction in the incidence of bronchopulmonary dysplasia (BPD) (RR 0.61, 95% CI 0.46 to 0.82) and duration of mechanical ventilation (mean difference (MD) -2.0 days, 95% CI -3.14 to -0.86). VTV modes also resulted in reductions in intraventricular haemorrhage (IVH) (RR 0.65, 95% CI 0.42 to 0.99), grade 3/4 IVH (RR 0.55, 95% CI 0.39 to 0.79), periventricular leukomalacia (PVL) (RR 0.33, 95% CI 0.15 to 0.72), pneumothorax (RR 0.52, 95% CI 0.29 to 0.93), failure of primary mode of ventilation (RR 0.64, 95% CI 0.43 to 0.94), hypocarbia (RR 0.56, 95% CI 0.33 to 0.96), mean airway pressure (MD -0.54 cmH2O, 95% CI -1.05 to -0.02) and days of supplemental oxygen administration (MD -1.68 days, 95% CI -2.47 to -0.88).
  
  
  CONCLUSIONS
  Preterm infants ventilated using VTV modes had reduced duration of mechanical ventilation, incidence of BPD, failure of primary mode of ventilation, hypocarbia, grade 3/4 IVH, pneumothorax and PVL compared with preterm infants ventilated using PLV modes. There was no evidence that infants ventilated with VTV modes had reduced death compared to infants ventilated using PLV modes.
authors.affiliation: Department of Pediatrics, the First Affiliated Hospital of Bengbu Medical College, , Bengbu, P.R. China.
authors.forename: Wansheng
authors.initials: W
authors.lastname: Peng
authors.forename: Hongwei
authors.initials: H
authors.lastname: Zhu
authors.forename: Hua
authors.initials: H
authors.lastname: Shi
authors.forename: EnMei
authors.initials: E
authors.lastname: Liu
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000628:therapy*; D013990:Tidal Volume / Q000502:physiology*
keywords: Intensive Care; Neonatology