title: Treatment of neonates with respiratory distress syndrome by proportional assist ventilation plus synchronized intermittent mandatory ventilation: a comparison study.
abstract: BACKGROUND
  The proportion assisted ventilation (PAV) can improve patient-ventilator interaction, reducing the incidence of end-expiratory asynchrony and increasing the time of synchrony. PAV could compensate for the leaks by elastic and resistive unloading and thus is ideal for neonates with uncuffed airways. The aim of this study was to compare the relevant clinical parameters of neonates with respiratory distress syndrome (RDS) who are supported by PAV plus synchronized intermittent mandatory ventilation (SIMV) and SIMV.
  
  
  METHODS
  Forty-six neonates diagnosed as RDS who required mechanical ventilation were randomly divided into observer group (support by PAV+SIMV mode, N.=23) and control group (support by SIMV mode, N.=23). The X-ray grading situation, the number of asynchrony-delayed trigger, mean arterial blood pressure (MABP), spontaneous respiratory rate (RR), heart rate (HR), blood gas analysis values and circulation and respiratory parameters at each timepoint after 30 minutes, 12, 24, 48 and 72 hours of mechanical ventilation were observed.
  
  
  RESULTS
  The forty-four neonates in two groups have been cured, the other 2 neonates (one in each group) gave up treatment and automatically discharged. There were no statistically significant differences in male, gestational age, body weight, duration of mechanical ventilation, oxygen dependence and hospital stay between the two groups (all P>0.05). There were no statistically significant differences in MABP, HR and ratio of arterial-to-alveolar partial pressure of oxygen (a/APO<inf>2</inf>) at each time point after mechanical ventilation between the two groups(all P>0.05). The number of asynchrony-delayed trigger in observer group was lower than that in control group, the difference was statistically significant (P<0.05). The number of spontaneous RR in observer group was higher than that in control group. The difference was statistically significant (P<0.05).
  
  
  CONCLUSIONS
  The PAV plus SIMV shows a good clinical effect in treatment of neonates with RDS. It could be better to use neonatal spontaneous breathing and might cause less damage to the lung than SIMV mode.
authors.affiliation: Yangzhou University Medical College, Neonatal Medical Center, Huai'an Maternity and Child Healthcare Hospital, Huai'an, China - wr618@163.com.
authors.forename: Rong
authors.initials: R
authors.lastname: Wu
authors.affiliation: Department of Neonatology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, China.
authors.forename: Zhao-Fang
authors.initials: ZF
authors.lastname: Tian
authors.affiliation: Department of Neonatology, Bayi Children's Hospital Affiliated to Army General Hospital, Beijing, China.
authors.forename: Xiang-Yong
authors.initials: XY
authors.lastname: Kong
authors.affiliation: Department of Neonatology, Bayi Children's Hospital Affiliated to Army General Hospital, Beijing, China.
authors.forename: Shao-Dong
authors.initials: SD
authors.lastname: Hua
authors.affiliation: Yangzhou University Medical College, Neonatal Medical Center, Huai'an Maternity and Child Healthcare Hospital, Huai'an, China.
authors.forename: Jin-Hui
authors.initials: JH
authors.lastname: Hu
authors.affiliation: Yangzhou University Medical College, Neonatal Medical Center, Huai'an Maternity and Child Healthcare Hospital, Huai'an, China.
authors.forename: Guo-Fang
authors.initials: GF
authors.lastname: Zhen
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D059725:Interactive Ventilatory Support; D007385:Intermittent Positive-Pressure Ventilation; D008297:Male; D010100:Oxygen; D012128:Respiratory Distress Syndrome; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy
chemical_list: D010100:Oxygen