Volume-targeted versus pressure-limited ventilation in infants born at or near term

Prashanth Bhat, Olie Chowdhury, Sandeep Shetty, Simon Hannam, Gerrard F. Rafferty, Janet Peacock, Anne Greenough*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)
256 Downloads (Pure)


Our aims were to determine whether volume-targeted ventilation (VTV) or pressure-limited ventilation (PLV) reduced the time to successful extubation and if any difference was explained by a lower work of breathing (WOB), better respiratory muscle strength or less thoracoabdominal asynchrony (TAA) and associated with fewer hypocarbic episodes. Infants born at ≥34 weeks of gestational age were randomised to VTV or PLV. The WOB was assessed by the transdiaphragmatic pressure time product, respiratory muscle strength by the maximum inflation (Pimax) and expiratory (Pemax) pressures and TAA assessed using uncalibrated respiratory inductance plethysmography. Forty infants, median gestational age of 39 (range 34–42) weeks, were recruited. The time to successful extubation did not differ between the two groups (median 25, range 2.5–312 h (VTV) versus 33.5, 1.312 h (PLV)) (p = 0.461). There were no significant differences between the groups with regard to the WOB, respiratory muscle strength or the TAA results. The median number of hypocarbic episodes was 1.5 (range 0–8) in the VTV group versus 4 (range 1–13) in the PLV group (p = 0.005). 

Conclusion: In infants born at or near term, VTV compared to PLV did not reduce the time to successful extubation but was associated with significantly fewer hypocarbic episodes.

Original languageEnglish
Pages (from-to)89-95
Number of pages7
JournalEuropean Journal of Pediatrics
Issue number1
Early online date4 Aug 2015
Publication statusPublished - Jan 2016


  • Extubation
  • Respiratory muscle strength
  • Thoracoabdominal asynchrony
  • Work of breathing


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