Abstract
In the U.K. reversed inspiratory to expiratory (I/E) ratios remain popular as a method of raising PaO2 during ventilation for I.R.D.S. Data is accumulating that infants currently developing I.R.D.S. are less mature than ten years ago (1,2). We have assessed the effect of a reversed I/E ratio on oxygenation in 33 infants ventilated for I.R.D.S. All babies were ventilated on Draeger Babylog ventilators. Ventilator changes were made using the ventilator controls but the accuracy of these changes were confirmed by a pressure transducer in the proximal portion of the endotracheal tube which measured the applied pressure, and a pneumotachograph/integrator/differential pressure transducer in series with the endotracheal tube which measured tidal volume. Improvements in PaO2 were very variable but most consistent in infants >1800 grams and <860 grams. The effect on PaO2 for infants of 851-1799 grams was disappointing (mean changes -0.1 mmHg n = 16). For many infants the use of the reversed I/E ratios needlessly raises mean airways pressure.
References
1. Field, Milner, Hopkin & Madeley. Changing nature of the overall workload in neonatal units. B.M.J. (In press)
2. Field. Milner, Hopkin & Madeley. Changing patterns of neonatal respiratory disease. Arch. Dis. Chlld. (Submitted)
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Field, D., Milner, A., Hopkin, I. et al. INSPIRATORY TO EXPIRATORY RATIOS DURING POSITIVE PRESSURE VENTILATION OF PRETERM INFANTS. Pediatr Res 19, 1100 (1985). https://doi.org/10.1203/00006450-198510000-00184
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DOI: https://doi.org/10.1203/00006450-198510000-00184
