se of the Guaranteed Volume mode as a ventilatory weaning strategy in Premature Newborns

Introduction: The diaphragm of preterm newborns is flat, weak, and horizontally inserted in the rib cage. Consequently, it hampers the lever mechanism during muscle contraction, reduces the efficiency of pulmonary ventilation and chest expansion, and increases energy expenditure. Objective: To assess chest expansion using inductance plethysmography in preterm newborns during assist-control ventilation and inspiratory pressure control with and without volume guarantee (VG and AC-PC, respectively). Methods: This is a crossover clinical trial. Ventilatory (peak pressure, minute volume, dynamic compliance, and airway resistance) and autonomic outcomes (heart rate, respiratory rate, and peripheral oxygen saturation) were measured at 0, 30, and 60 minutes after initiation of ventilation. Paired t-test compared ventilation modes and times (0, 30, and 60 minutes). Results: We included ten preterm newborns (mean gestational age of 30 ± 1.89 weeks and weight of 964 ± 167.1 grams). VG increased chest expansion and peripheral oxygen saturation and reduced respiratory distress compared with AC-PC. Conclusion: VG may increase chest expansion and peripheral oxygen saturation and reduce respiratory distress and heart rate compared with AC-CP mode. Also, inductance plethysmography may be viable for measuring chest expansion during mechanical ventilation.