Comparison study of pressure regulated volume control ventilation and synchronized intermittent mandatory ventilation in treating neonates with respiratory distress syndrome

Objective To observe the changes of related parameter of neonates with respiratory distress syndrome(RDS)ventilated by pressure regulated volume control ventilation(PRVC) and synchronized intermittent mandatory ventilation(SIMV). Methods From June 2013 to March 2014, in Maternity and Child Health Care Hospital of Huai'an City, 58cases of neonates with respiratory distress syndrome(RDS) who required mechanical ventilationwere were divided into PRVC group(32 cases, ventilated by PRVC) and SIMV group(26 cases, ventilated by SIMV), and the values of related clinical and respirator parameters were recorded and analyzed. The mechanical ventilation time, oxygen cure time, hospital stay and arterial oxygen partial pressure/alveolar oxygen partial pressure. The incidence of acidemia, alkalemia and low carbonate and hypercapnia in two groups were observed. The changes of heart rate(HR), respiratory rate(RR), mean arterial blood pressure(MABP), peak inspiratory pressure(PIP) and oxygenation index(OI)when at mechanical ventilation for 1, 12, 24, 48 and 72 hours in two groups were observed. Results ①All 58 cases of neonates with respiratory distress syndrome(RDS) were recovered, there were no statistically significant differences between the two groups in the time of mechanical ventilation, oxygen therapy time, the hospitalization time, the incidence of intracranial bleeding, the incidence of bronchial dysplasia and the incidence of ventilator-associated pneumonia(P 0.05). ②The changes of HR and RR showed downtrend, and were in the normal range at mechanical ventilation for 72 hours in two groups. The changes of MABP in the two groups were in normal range. ③ The changes of PIP showed downtrend in two groups. PIP at the different time in the different group were compared, the differences were statistically significant(P 0.05). PIP in PRVC group were lower than those in SIMV group at mechanical ventilation for 1,12, 24, 48 and 72 hours, the differences were statistically significant(P 0.05). ④The changes of OI showed downtrend. OI at the different time in the different group were compared, the differences were statistically significant(P 0.05). in PRVC group were compared with those in SIMV group at mechanical ventilation for 1, 12, 24, 48 hours, the differences were not statistically significant(P 0.05). OI in PRVC group was lower than that in SIMV group at mechanical ventilation for 72 hours, the difference was statistically significant(P 0.05). ⑤There was no statistically significant difference between two groups in the incidence of pH7.35(PRVC group was 16.5%, SIMVwas 13.5%) and pH7.45(PRVC group was 7.8%, SIMV was 5.2%) when at the mechanical ventilation(P 0.05). The incidence of PaCO235 mm Hg in PRVC group was lower than that in SIMV group at mechanical ventilation, the difference was statistically significant(P 0.05). There was no statistically significant difference between two groups in the incidence of PaCO260 mm Hg when at mechanical ventilation(P 0.05). Conclusion In the case to achieve the same of effect, the PIP and the incidence of hyperventilation in PRVC mode are significantly lower than that of in SIMV mode. So the PRVC mode may has some certain value in clinical application and worth of promotion.