To study the effects of low values set on a breath delivering machine and time taken to take off the support from machine

Completed

Conditions: Unspecified acute lower respiratory infection,

Registration Number: CTRI/2018/10/016021

Lead Sponsor: Aathira Rajan

Brief Summary: All newborns from 26- 37 weeks of gestation requiring mechanical ventilation admitted at the NICU. Neonates will be recruited from the time of initiation of ventilation. The initial mode of ventilation was SIMV and once they are ready to wean, the mode was switched over to PSV Hemodynamic and ventilator parameters will be recorded throughout the PSV trial at two-time points of which one was at the initiation of PSV and another at thirty minutes of PSV. On PSV mode vitals signs( heart rate, respiratory rate, SpO2)and ventilator parameters ( Pressure support, FiO2, PEEP, flow, mean airway pressure,tidal volume, compliance) and calculated parameters( respiratory severity score and C20/C,Sp02 /FiO2 ratio)were recorded during PSV trial and once the neonates were ready, they were extubated and put on non invasive mode of ventilation. A total of 22 neonates were enrolled for the study during the time period. Set parameters measured parameters and calculated parameters were recorded during thirty minutes PSV trial. We did not observe any changes in hemodynamic, set or measured ventilator parameters throughout the trial and the incidence of reintubation was found to be five of which two reintubated within 72 hours due to severe hypoxemia and three after 72hours due to inadequate secretion clearance and severe bleeding associated with surgery. Mean airway pressure (MAP) among PSV and SIMV mode was also analyzed, MAP was found to be less in PSV mode with p <0.0001 which could be explained because of the less pressure used during PSV rather than in SIMV mode ,on which mean airway could have been influenced by inspiratory time, pressure control and set respiratory rate. Since there were no observed hemodynamic instability or any deterioration in ventilation at the end of thirty minutes of PSV, explained by stable ventilation not requiring any increase in ventilatory parameters to achieve the target indicate the safety of PSV mode in neonates as an independent mode. Thus it is concluded that PSV can be used in neonates with proper monitoring.

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 90

Inclusion Criteria

All newborn infants 26-37 weeks requiring mechanical ventilation.

Exclusion Criteria

newborns with congenital heart disease, air leak syndrome , hemodynamic instability and without inform consent.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
duration of time between weaning and early extubation	duration of time between weaning and early extubation

Secondary Outcome Measures

Name	Time	Method
Requiring reintubation within 48 hours	Mean airway pressure on PSV and SIMV

Trial Locations

Locations (1): Kasturba hospital
🇮🇳
Kannada, KARNATAKA, India
Kasturba hospital
🇮🇳Kannada, KARNATAKA, India
Aathira Rajan
Principal investigator
9663908238
aathirarajan1995@gmail.com