Inspiratory time and pulmonary function in mechanically ventilated babies with chronic lung disease

To learn if increasing inspiratory time would improve pulmonary function in mechanically ventilated babies with chronic lung disease, we measured lung mechanics and alveolar ventilation at three inspiratory times: 0.4, 0.6, and 0.8 s. Nine babies were studied. Their mean birth weight was 875 g (range, 570-1,100 g), gestational age 27 (24-34) weeks, and age 7 (4-12) weeks. Their mean oxygen requirement was 40% (29-53), ventilator rate 33/min (20-40), and mean airway pressure 8 (5-10) cmH2O. Ventilator rate was kept constant; therefore expiratory time decreased and mean airway pressure and I:E ratio increased at longer inspiratory times. At 0.6 s and 0.8 s, when compared to 0.4 s, significant increases occurred in tidal volume (10.4, 10.1, and 8.4 mL/kg, respectively), dynamic lung compliance (0.68, 0.68, and 0.53 mL/cmH2O/kg, respectively), and alveolar ventilation (6.0, 6.3, and 4.7 mL/kg/breath, respectively). Airway resistance, anatomical dead space to tidal volume ratio, and functional residual capacity were similar at the three inspiratory times. Our findings suggest that an inspiratory time greater than or equal to 0.6 s (compared to 0.4 s) increases the effectiveness of mechanical ventilation for babies with chronic lung disease.