Ventilation Practices in the Neonatal Intensive Care Unit: A Cross-Sectional Study.

Objective: To assess current ventilation practices in newborn infants.
Study design: We conducted a 2-point cross-sectional study in 173 European neonatal intensive care units, including 535 infants (mean gestational age 28 wks and birth weight 1024 g). Patient characteristics, ventilator settings and measurements were collected bedside from endotracheally ventilated infants.
Results: 457 (85%) of the patients were conventionally ventilated. Time cycled pressure limited (TCPL) ventilation was used in 59% of these patients, most often combined with synchronized intermittent mandatory ventilation (51%). Newer conventional ventilation modes like volume targeted and pressure support ventilation were used in, respectively, 9% and 7% of the patients. The mean tidal volume, measured in 84% of the conventionally ventilated patients, was 5.7±2.3 ml/kg. The mean positive end-expiratory pressure (PEEP) was 4.5±1.1 cmH2O and rarely exceeded 7 cmH2O.
Conclusions: TCPL ventilation is the most commonly used mode in neonatal ventilation. Tidal volumes are usually targeted between 4–7 ml/kg and PEEP between 4–6 cmH2O. Newer ventilation modes are only used in a minority of patients.