Volume-targeted ventilation

• Published in: Seminars in perinatology Vol. 48; no. 2; p. 151886
• Main Authors: Keszler, Martin, Abubakar, M. Kabir
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2024
• Subjects: Humans; Infant, Extremely Premature; Infant, Newborn; Lung; Lung-protective ventilation; Mechanical ventilation; Open lung; Respiration, Artificial; Tidal volume; Tidal Volume - physiology; Ventilator-associated lung injury; Volume-targeted ventilation; Ventilator-associated lung injury; Open lung; Volume-targeted ventilation; Mechanical ventilation; Lung-protective ventilation; Tidal volume
• ISSN: 0146-0005; 1558-075X
• DOI: 10.1016/j.semperi.2024.151886

Despite strong evidence of important benefits of volume-targeted ventilation, many high-risk extremely preterm infants continue to receive traditional pressure-controlled ventilation in the United States and elesewhere. Reluctance to abandon one's comfort zone, lack of suitable equipment and a lack of understanding of the subtleties of volume-targeted ventilation appear to contribute to the relatively slow uptake of volume-targeted ventilation. This review will underscore the benefits of using tidal volume as the primary control variable, to improve clinicians’ understanding of the way volume-targeted ventilation interacts with the awake, breathing infant and to provide information about evidence-based tidal volume targets in various circmstances. Focus on underlying lung pathophysiology, individualized ventilator settings and tidal volume targets are essential to successful use of this approach thereby improving important clinical outcomes.