Does measuring respiratory function improve neonatal ventilation?

Abstract

AIMS: To determine whether using a respiratory function monitor alters clinicians' choice of ventilator settings, tidal volumes or blood gases in the first 48 h of ventilation. METHODS: Clinicians were trained to use a respiratory function monitor to optimize neonatal ventilation. Thirty-five infants, weighing < 2 kg, treated with the Infant Star ventilator were randomized to have a respiratory function monitor display visible or concealed. All reasons for altering ventilator settings were noted. Data on ventilator parameters and clinical care were collected hourly. The primary outcome was the mean peak pressure used during the first 48 h. RESULTS: There were no statistically significant differences in peak pressures, tidal volumes or arterial carbon dioxide levels between the two groups. CONCLUSIONS: Using the Florian respiratory function monitor in the first 48 h of ventilation with the Infant Star ventilator did not alter the choice of ventilator settings, tidal or minute volumes or arterial blood gases. Possible explanations for this result include lack of power due to the small numbers recruited and bias due to the unblinded nature of the trial.