COMPARING THE EFFECTS OF VOLUME-TARGETED VENTILATION MODE AND TRADITIONAL PRESSURE-LIMITED VENTILATION MODE ON THE CLINICAL OUTCOMES OF PREMATURE BABIES WITH RESPIRATORY DISTRESS SYNDROME. A CONTROLLED RANDOMIZED STUDY
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Date
2023-09-03
Authors
Reem Ataya
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Abstract
Respiratory distress syndrome (RDS) occurs when the lungs of a premature infant are not fully developed and lack the surfactant needed to keep the air sacs open. Different modes of ventilation have evolved to decrease the lung damage of the premature infant and control the amount of air that enters the lungs with each inflation. The most commonly used modes are the traditional Pressure-Limited Ventilation (PLV) and the new Volume Targeted Pressure (VTV).
The study aims to compare the effect of VTV and PLV on the clinical outcome (BP, RR, HR, SaO2, Tidal volumes and FiO2), length of intubation duration, Oxygen therapy duration and the consequent complications of the premature babies with RDS in Jenin Governmental Hospital.
The study used a randomised controlled trial design. 80 premature babies made up the sample, of which 40 were randomly assigned to the experimental group (VTV) and 40 to the control group (PVL). The data was gathered using the patient data sheet.
The total number of male participants was 42 (27 VTV and 15 PLV), while the total number of females was 38 (13 VTV and 25 PLV). The gestational age ranged from 29 to 36 weeks. In this study 32.5 % of all the participants were in the age group between 0-7 days, while 11.3% were in the age group from 22-24 days. The highest birth weight group was from 1.51 to 2.5 Kg (46.3%), while the lowest was more than 3.5 kg (1.3%). The weight of the largest number of the participants from the two groups ranged between 1.51 to 2.5 kg, while those weighting more than 3.5 kg were the lowest number of the participants. A total of 37.5% of participants delivered by normal vaginal delivery, while 62.5% of participants delivered by caesarean section. The mean of Spo2 in VTV (Mean=97.7) at the total 24 hours was significantly higher than the mean in PLV (Mean=95.86). There are significant differences between VTV group and PLV group in the FiO2 at the sixth, seventh and eighth 3 hours. The number of dead patients in the PLV 8(20%) was higher than in the VTV 3(7.5%), P= 0.105. However, there was no statistical significance in difference, but clinically it was relevant. The study could not identify an increase in any adverse outcomes associated with the use of VTV compared with PLV.
VTV mode produced improved oxygen saturation values for SPO2, and FiO2 in comparison to PLV mode, The results showed that the number of dead patients in the PLV group was higher than in the VTV. However, there was no statistical significance in difference, but clinically it was relevant. There was no evidence of an increase in any unfavourable outcomes associated with the use of VTV in comparison to PLV.
Keywords: VTV, PLV, Premature, RDS, Palestine.