Professor Gabriel Dimitriou coauthored the inital review of this subject (1998) and the review updates (2001 and 2004).
Dr. Michael Prendergast coauthored this 2007 review update.
Two additional studies were identified as eligible for inclusion and additional studies were designated as "excluded studies". Two further triggered modes are included: pressure support and pressure regulated volume control ventilation have been included
Study | Methods | Participants | Interventions | Outcomes | Notes | Allocation concealment |
Baumer 2000 | Randomized. Multicenter trial. Randomization method: randomly allocation by telephone. Stratified by centre. Within each centre, randomisation in blocks to ensure a similar distribution of babies in each arm of the study. Blinding of randomization: yes | Gestational age <32 weeks. Assisted ventilation within 72 hours of birth. Not ventilated for more than 6 hours at randomisation. RDS. Exclusion: major congenital malformation or inhalational pneumonitis Sample size 924 PTV: 465 CMV: 459 | PTV vs CMV | Primary: Hospital mortality or need for oxygen treatment at 36 weeks of gestation; pneumothorax; cerebral ultrasound abnormality nearest to 36 weeks of gestation; duration of ventilation in survivors. | Ventilator types: PTV: SLE 2000 (airway pressure trigger), Draeger babylog 8000 (airway flow trigger). CMV: SLE 2000, Draeger Babylog, Sechrist. 423 of those randomized to PTV and 422 infants randomized to CMV had cranial ultrasound examination. | A |
Beresford 2000 | Randomized. Multicenter trial Randomization method: computer generated sequence hidden in sequentially numbered, opaque envelopes. Stratified by BW. Blinding of randomization:yes Blinding of intervention:no Complete follow up:no Blinding of outcome measurement:no | Birthweight 1000-2000 gm. Assisted ventilation within 24 hours of birth. RDS. Exclusion: major malformations, congenital heart disease, MAS. Sample size 386 PTV:193 CMV:193 | PTV vs CMV | Primary: Incidence of CLD Secondary: Death. Pneumothorax IVH Cystic PVL Shunt insertion. | Ventilator types: SLE 2000 (airway pressure trigger). | A |
Bernstein 1996 | Randomized. Multicenter trial Intention-to-treat basis Randomization method: sealed, opaque envelopes .Stratified by BW. Blinding of randomization:yes | Birthweight >500gm. Assisted ventilation. Age <36hrs. RDS, congenital pneumonia, MAS. CxR with abnormal lung parenchyma, FiO2>0.4(all BW) and MAP>7 cmH2O (for infants with BW >1250 gm). Duration of CMV prior randomization <12 hrs, spontaneous breathing rate >20 bpm and indwelling arterial line. Exclusion: infants with air leak, seizures, IVH grade III or IV, neuromuscular disease affecting respiration, major malformations including chromosomal abnormalities, CDH, CHD (except PDA), lung hypoplasia, septic shock or severe skin disease. Sample size 350* SIMV:178 (167 analyzed) CMV:172 (160 analyzed) *23 excluded post randomization | SIMV vs CMV | Primary: Acute effect on oxygenation Sedative/analgesic drug requirements Duration of ventilation. Air leaks Secondary: Severe IVH Death. Need for pharmacological paralysis, ECMO or long term supplemental oxygen The age at which infants undergoing long-term ventilation (>14 days) regained their BW | Ventilator types: Infant Star with Star Sync module (abdominal movement monitor) | A |
Chan 1993 | Randomized. Single centre trial. Randomization method: sealed, opaque envelopes. Blinding of randomization:yes Blinding of intervention:no Complete follow up:no Blinding of outcome measurement:no | Gestational age <36 weeks. Age: 1-21 days. RDS. In the recovery stage of the respiratory disease (at 40bpm). Sample size 40 PTV:20 CMV:20 | PTV vs CMV | Primary: Hours of ventilation from entering the study until first extubation (weaning). Secondary: Number of infants failed weaning. Number of infants failed extubation | Ventilator types: SLE 2000 (airway pressure trigger), Sechrist IV-100B | A |
Chan 1994 | Randomized. Single centre trial Randomization method: sealed, opaque envelopes. Blinding of randomization:yes Blinding of intervention:no Complete follow up:no Blinding of outcome measurement:no | GA<35 weeks Age < 1-23 days Weaning -loaded with aminophylline Exclusion: apnoea, failure to trigger Sample size 40 SIMV:20 CMV:20 | PTV vs SIMV | Primary: Duration of weaning Secondary: Number of infants who failed weaning Number of infants who failed extubation | Ventilator types: SLE 2000 (airway pressure trigger) CMV | A |
Chen 1997 | Randomized. Single centre trial Blinding of randomization: not stated Blinding of intervention:no Complete follow up:no Blinding of outcome measurement:no | BW<1.75 kg,GA <34 w and RDS. Assisted ventilation. Exclusion: congenital malformation, inherited metabolic abnormalities, sepsis, treatment with muscle relaxants. Sample size 77 SIMV:38 CMV:39 RDS sample size:62 SIMV:31 CMV:31 MAS sample size:15 SIMV:7 CMV:8 Term infants (MAS) excluded from the analysis. | SIMV vs CMV | Primary: Duration of ventilation. Need of reintubation. Air leaks, PDA, IVH. Secondary: BPD, ROP Death. | Ventilator types: Infant star with Star sync module (airflow trigger) (CMV) Bear-Cub | B |
D'Angio 2005 | Randomized Single centre trial Randomization method: block randomization scheme by one of the investigators Blinding of randomization: yes Blinding of intervention: no Complete follow up: no Blinding of outcome measurement: no | Ventilated infants BW of 500-1249 gm Less than six hours of age Gestational age > 24 weeks Sample size 212 PRVCV 104 SIMV 108 | PRVCV vs SIMV | Primary: Proportion of infants alive and extubated at 14 days Secondary: Death Moderate/severe BPD Airleaks Severe IVH (grades 3 and 4) | Ventilator type: Servo 300, infants who required slow rates > 40 bpm (maximum for the Servo 300) were transferred to the BIRD VIP ventilator | A |
Dimitriou 1995a | Randomized. Single centre trial Randomization method: sealed, opaque envelopes. Blinding of randomization:yes Blinding of intervention:no Complete follow up:no Blinding of outcome measurement:no | GA<35 weeks Age <15 days Weaning -loaded with aminophylline Exclusion: apnoea, failure to trigger Sample size 40 PTV:20 SIMV:20 | PTV vs SIMV | Primary: Duration of weaning Secondary: Number of infants failed weaning Number of infants who failed extubation | Ventilator types: SLE 2000 (airway pressure trigger) | A |
Dimitriou 1995b | Randomized. Single centre trial Randomization method: sealed, opaque envelopes. Blinding of randomization:yes Blinding of intervention:no Complete follow up:no Blinding of outcome measurement:no | GA <35 weeks Age <15 days Weaning - loaded with aminophylline Exclusion: apnoea, failure to trigger Sample size 40 PTV:20 SIMV:20 | PTV vs SIMV | Primary: Duration of weaning Secondary: Number of infants who failed weaning Number of infants who failed extubation | Ventilator types: SLE 2000 (airway pressure trigger) | A |
Donn 1994 | Randomized Single centre trial Randomization method:lottery (sampling without replacement) Blinding of randomization : not reported Blinding of intervention:no Complete follow up:no Blinding of outcome measurement:no | Preterm infants. BW between 1.1-1.5 kg, RDS, SRT Sample size 30 PTV:15 CMV:15 | PTV vs CMV | Primary: Duration of ventilation Secondary: Airleaks IVH CLD | Ventilator types: PTV V.I.P. BIRD (airflow trigger) CMV Sechrist IV-100B, V.I.P BIRD | B |
Heicher 1981 | Quasi-randomised. Single center trial. Patients alternatively assigned to one of the two study ventilatory modes Blinding of randomization:no Blinding of intervention:no Complete follow up:no Blinding of outcome measurement:no | Birthweight > 750 gm. No gross anomalies. Abnormal lung fields on chest radiograph. Respiratory distress syndrome, pneumonia Exclusion: infants with chromosomal abnormalities or meconium aspiration Sample size 102 Rapid rates:51 Slow rates:51 | HFPPV. Rapid rates (60bpm) with IT: 0.5 sec versus slow rates (20-40 bpm) with IT:1sec | Clinical improvement. Need for pharmacological paralysis. Hours of assisted ventilation. Hours of FiO2> 0.6. CLD. Mortality. | Ventilator types: Baby Bird, Bird Co. | C |
OCTAVE 1991 | Randomized Multicenter trial Randomization method: sealed, opaque envelopes. Blinding of randomization:yes Blinding of intervention:no Complete follow up:yes Blinding of outcome measurement:no | Age<72 hrs. Assisted ventilation. Exclusion: meconium aspiration Sample size 346 HFPPV : 174 LFPPV : 172 | HFPPV (60bpm) versus LFPPV (20-40 bpm) | Incidence of pneumothorax. Incidence and severity of CLD. Mortality. Neurodevelopmental outcome. | Ventilator type: Sechrist IV 100B | A |
Pohlandt 1992 | Randomized (with stratification for gestational age). Method of randomization: random number table. Blinding of randomization : not reported Blinding of intervention:no Complete follow up:no Blinding of outcome measurement:no | Gestational age <32 weeks. Assisted ventilation. Supplemental FiO2 >0.4. Sample size 181 HFPPV : 91 LFPPV : 90 | HFPPV (60 bpm with IT:0.3 sec) vs LFPPV ( 30-40 bpm with IT:1 sec) | Incidence of extra-alveolar air leaks. Mortality. | Ventilator types: AIV Loosco MKII, Biomed MVP 10, Babylog-Draeger, Sechrist IV-100B, Siemens Servo -B and Servo-C, Stephan. 181 infants were enrolled into the study, but only 137 fulfilled the criteria and their results were analyzed. | B |
Reyes 2006 | Randomized Single centre Randomization method: sequential Sealed opaque envelopes from a computer generated randomized list Blinding of randomization : no Complete follow up: yes Blinding of outcome measurement: no | Birthweight 500-1000 gm appropriate birthweight for gestational age Mechanical ventilation requirement < 12 hours after birth until 7 days Exclusion: congenital anomalies; neuromuscular disease; lung hypoplasia; congenital heart disease; hypotension requiring intravenous medication; PIE or pneumothorax; required HFOV > 24 hours; received sedation or muscle relaxation Sample size: 107 53 SIMV plus PS 54 SIMV | SIMV plus PS versus SIMV | Primary: Proportion of infants requiring supplementary oxygen at 28 days Secondary: Death Airleaks BPD IVH (Grades III and IV) (Grade III and IVH) | Ventilator type: Pressure limited flow triggered VIP ventilator | C |
Study | Reason for exclusion |
Abd El-Moneim 2005 | Short term cross over study |
Abubakar 2005 | Randomised short term cross over study |
Amitay 1993 | Not assigned respiratory support mode by randomization |
Bernstein 1993 | Not assigned respiratory support mode by randomization |
Chan 1993b | Not assigned respiratory support mode by randomization |
Cheema 2001 | Short term comparison of volume guarantee synchronized ventilation to PTV or SIMV |
Cleary 1995 | Acute effects of synchronized ventilation |
Courtney 2002 | Randomised comparison of HFOV to SIMV |
Craft 2003 | Randomised comparison of SIMV to High Frequency Flow Interrupter |
Dani 2006 | Short term randomized comparison of PSV with VG to HFOV |
deBoer 1993 | Not assigned respiratory support mode by randomization |
Dimitriou 1998 | Comparison of triggering devices |
Durand 2001 | Randomised pilot study comparing HFOV to SIMV |
Firme 2005 | Randomised short term cross over study |
Friedlich 1999 | Nasopharyngeal SIMV versus CPAP |
Greenough 1986 | Not assigned respiratory support mode by randomization |
Greenough 1987a | Not assigned respiratory support mode by randomization |
Greenough 1987b | Not assigned respiratory support mode by randomization |
Greenough 1988a | Not assigned respiratory support mode by randomization |
Greenough 1988b | Not assigned respiratory support mode by randomization |
Greenough 1991 | Not assigned respiratory support mode by randomization |
Guthrie 2005 | Randomised short term comparison of SIMV and mandatory minute volume |
Herrera 2002 | Acute effects of volume-guaranteed SIMV |
Hird 1990a | Not assigned respiratory support mode by randomization |
Hird 1990b | Not assigned respiratory support mode by randomization |
Hird 1991a | Not assigned respiratory support mode by randomization |
Hird 1991b | Not assigned respiratory support mode by randomization |
Hird 1991c | Not assigned respiratory support mode by randomization |
Hird 1991d | Not assigned respiratory support mode by randomization |
Hummler 1996 | Acute effects of synchronized ventilation |
Hummler 1997 | Acute effects of mechanical ventilation |
Hummler 2006 | Randomised short term cross over study |
Jaber 2005 | Randomised short term cross over comparison of PSV and volume support ventilation |
Jarreau 1996 | Acute outcome of synchronized ventilation |
John 1994 | Comparison of triggering devices |
Kapasi 1999 | Short term randomized comparison of ventilation modes |
Keszler 2004 | Short term randomised comparison of ventilation modes with ACV with or without volume guarantee |
Laubscher 1997 | Comparison of triggering devices |
Lista 2006 | Acute effects of different levels of volume targetting during synchronised intermittent positive pressure ventilation with the context of a randomised trial |
Luyt 2001 | Acute effects of PTV and conventional ventilation compared within the context of a randomised trial |
Migliori 2003 | Non randomised comparison of pressure support synchronized ventilation and SIMV |
Mitchell 1989 | Not assigned respiratory support mode by randomization |
Mizuno 1994a | Not assigned respiratory support mode by randomization |
Mizuno 1994b | Not assigned respiratory support mode by randomization |
Moretti 1999 | Nasal SIPPV to nasal CPAP |
Mrozek 2000 | Randomised comparison (short-term) of volume-targeted synchronized ventilation and CMV |
Nafday 2005 | Randomised comparison (short term) of pressure support with volume guarantee |
Nakae 1998 | Comparison of triggering devices |
Nikischin 1996 | Comparison of triggering devices |
Nishimura 1995 | Comparison of triggering devices |
Olsen 2002 | Cross over trial comparing pressure support with volume guarantee synchronized ventilation to SIMV |
Osorio 2005 | Cross over short term comparison of SIMV with or without pressure support |
Polimeni 2006 | Short term cross over study |
Servant 1992 | Not assigned respiratory support mode by randomization |
Smith 1997 | Acute outcome of synchronized ventilation |
Takeuchi 1994 | Not assigned respiratory support mode by randomization |
Tanaka 1995 | Not assigned respiratory support mode by randomization |
Thiagarajan 2004 | Comparison of triggering devices |
Upton 1990 | Not assigned respiratory support mode by randomization |
Vishveshwara 1991 | Not assigned respiratory support mode by randomization |
Baumer JH. International randomised controlled trial of patient triggered ventilation in neonatal respiratory distress syndrome. Archives of Disease in Childhood 2000;82:F5-F10.
Beresford 2000 {published data only}
Beresford MW, Shaw NJ, Manning D. Randomised controlled trial of patient triggered and conventional fast rate ventilation in neonatal respiratory distress syndrome. Archives of Disease in Childhood 2000;82:F14-18.
Bernstein 1996 {published data only}
Bernstein G, Mannino FL, Heldt GP, Callahan JD, Bull DH, Sola A, Ariagno RL, Hoffman GL, Frantz ID, Troche BI, Roberts JL, Dela Cruz TV, Costa E. Randomized multicenter trial comparing synchronized and conventional intermittent mandatory ventilation in neonates. Journal of Pediatrics 1996;128:453-63.
Chan 1993 {published data only}
Chan V, Greenough A. Randomised controlled trial of weaning by patient triggered ventilation or conventional ventilation. European Journal of Pediatrics 1993;152:51-4.
Chan 1994 {published data only}
Chan V, Greenough A. Comparison of weaning by patient triggered ventilation or synchronous mandatory intermittent ventilation. Acta Paediatrica 1994;83:335-7.
Chen 1997 {published data only}
Chen J-Y, Ling U-P, Chen J-H. Comparison of synchronized and conventional intermittent mandatory ventilation in neonates. Acta Paediatrica Japonica 1997;39:578-83.
D'Angio 2005 {published data only}
D'Angio CT, Chess PR, Kovacs SJ, Sinkin RA, Phelps DL, Kendig JW et al. Pressure-regulated volume control ventilation vs synchronized intermittent mandatory ventilation for very low birthweight infants. Archives of Pediatric and Adolescent Medicine 2005;159:868-75.
Dimitriou 1995a {published data only}
Dimitriou G, Greenough A, Giffin FJ, Chan V. Synchronous intermittent mandatory ventilation modes versus patient triggered ventilation during weaning. Archives of Disease in Childhood 1995;72:F188-90.
Dimitriou 1995b {published data only}
Dimitriou G, Greenough A, Giffin FJ, Chan V. Synchronous intermittent mandatory ventilation modes versus patient triggered ventilation during weaning. Archives of Disease in Childhood 1995;72:F188-90.
Donn 1994 {published data only}
Donn SM, Nicks JJ, Becker MA. Flow-synchronized ventilation of preterm infants with respiratory distress syndrome. Journal of Perinatology 1994;14:90-4.
Heicher 1981 {published data only}
Heicher DA, Kasting DS, Harrod JR. Prospective clinical comparison of two methods for mechanical ventilation of neonates: rapid rate and short inspiratory time versus slow rate and long inspiratory time. Journal of Pediatrics 1981;98:957-61.
OCTAVE 1991 {published data only}
Oxford Region Controlled Trial of Artificial Ventilation (OCTAVE) Study Group. Multicentre randomised controlled trial of high against low frequency positive pressure ventilation. Archives of Disease in Childhood 1991;66:770-5.
Pohlandt 1992 {published data only}
Pohlandt F, Saule H, Schrîder H, Leonhardt A, Hîrnchen H, Wolff C, Bernsau U, Oppermann H-C. Decreased incidence of extra-alveolar air leakage or death prior to air leakage in high versus low rate positive pressure ventilation: results of a randomised seven-centre trial in preterm infants. European Journal of Pediatrics 1992;151:904-9.
Reyes 2006 {published data only}
Reyes ZC, Claure N, Tauscher MK, D'Ugard C, Vanbuskirk S, Bancalari E. Randomized, controlled trial comparing synchronized intermittent mandatory ventilation and synchronized intermittent mandatory ventilation plus pressure support in preterm infants. Pediatrics 2006;118:1409-17.
Abd El-Moneim ES, Fuerste HO, Krueger M, Elmagd AA, Brandis M, Schulte-Moenting J, Hentschel R. Pressure support ventilation combined with volume guarantee versus synchronized intermittent mandatory ventilation: a pilot crossover trial in premature infants in their weaning phase. Critical Care Medicine 2005;6:286-92.
Abubakar 2005 {published data only}
Abubakar K, Keszler M. Effect of volume guarantee combined with assist/control vs synchronized intermittent mandatory ventilation. Journal of Perinatology 2005;25:638-42.
Amitay 1993 {published data only}
Amitay M, Etches PC, Finer NN, Maidens JM. Synchronous mechanical ventilation of the neonate with respiratory disease. Critical Care Medicine 1993;21:118-24.
Bernstein 1993 {published data only}
Bernstein G, Cleary JP, Heldt GP, Rosas JF, Schellenberg l, Mannino FL. Response time and reliability of three neonatal patient triggered ventilators. American Review of Respiratory Disease 1993;148:358-64.
Chan 1993b {published data only}
Chan V, Greenough A. Neonatal patient triggered ventilators. Performance in acute and chronic lung disease. Br J Int Care 1993;3:216-9.
Cheema 2001 {published data only}
Cheema IU, Ahluwalia JS. Feasibility of tidal volume-guided ventilation in newborn infants: a randomized, crossover trial using the volume guarantee modality. Pediatrics 2001;107:1323-8.
Cleary 1995 {published data only}
Cleary JP, Bernstein G, Mannino FL, Heldt BP. Improved oxygenation during synchronized intermittent mandatory ventilation in neonates with respiratory distress syndrome: a randomized, crossover study. Journal of Pediatrics 1995;126:407-11.
Courtney 2002 {published data only}
Courtney SE, Durand DJ, Asselin JM, Hudak ML, Aschner JL, Shoemaker CT. High-Frequency Oscillatory ventilation versus convetional mechanical ventilation for very-low birth-weight infants. New England Journal of Medicine 2002;347:643-52.
Craft 2003 {published data only}
Craft AP, Bhandari V, Finer NN. The sy-fi study: a randomized prospective trial of synchronized intermittent mandatory ventilation versus a high-frequency flow interrupter in infants less than 1000 g. Journal of Perinatology 2003;23:14-9.
Dani 2006 {published data only}
Dani C, Bertini G, Pezzati M, Filippi L, Pratesi S, Caviglioli C, Rubaltelli FF. Effects of pressure support ventilation plus volume guarantee vs high-frequency oscillatory ventilation on lung inflammation in preterm infants. Pediatric Pulmonology 2006;41:242-9.
deBoer 1993 {published data only}
de Boer RC, Jones A, Ward PS, Baumer JH. Long term trigger ventilation in neonatal respiratory distress syndrome. Archives of Disease in Childhood 1993;68:308-11.
Dimitriou 1998 {published data only}
Dimitriou G, Greenough A, Lauscher B, Yamaguchi N. Comparison of airway pressure triggered and airflow triggered ventilation in immature infants. Acta Paediatrica 1998;87:1256-60.
Durand 2001 {published data only}
Durand DJ, Asselin JM, Hudak ML, Aschner JL, McArtor RD, Cleary JP, VanMeurs KP, Stewart DL, Shoemaker CT, Wiswell TE, Courtney SE. Early high-frequency oscillatory ventilation versus synchronized intermittent mandatory ventilation in very low birth weight infants: a pilot study of two ventilation protocols. Journal of Perinatology 2001;21:221-9.
Firme 2005 {published data only}
Firme SR, McEvoy CT, Alconcel C, Tanner J, Durand M. Episodes of hypoxemia during synchronized intermittent mandatory ventilation in ventilator-dependent very low birth weight infants. Pediatric Pulmonology 2005;40:9-14.
Friedlich 1999 {published data only}
Friedlich P, Lecart C, Posen R, Ramicone E, Chan L, Ramanathan R. A randomized trial of nasopharyngeal synchronized interittent mandatory ventilation versus nasopharyngeal continuous positive airway pressure in very low birthweight infants after extubation. Journal of Perinatology 1999;19:413-18.
Greenough 1986 {published data only}
Greenough A, Morley CJ, Pool J. Fighting the ventilator - are fast rates an effective alternative to paralysis? Early Human Development 1986;13:189-94.
Greenough 1987a {published data only}
Greenough A, Pool J, Greenall F, Morley CJ, Gamsu H. Comparison of different rates of artificial ventilation in preterm neonates with the respiratory distress syndrome. Acta Paediatrica Scandinavica 1987;76:706-12.
Greenough 1987b {published data only}
Greenough A, Greenall F, Gamsu H. Synchronous respiration - which ventilator rate is best? Acta Paediatrica Scandinavica 1987;76:713-18.
Greenough 1988a {published data only}
Greenough A, Greenall F. Patient triggered ventilation in premature neonates. Archives of Disease in Childhood 1988;63:77-8.
Greenough 1988b {published data only}
Greenough A, Pool J. Neonatal patient triggered ventilation. Archives of Disease in Childhood 1988;63:394-7.
Greenough 1991 {published data only}
Greenough A, Hird MF, Chan V. Airway pressure triggered ventilation for preterm neonates. Journal of Perinatal Medicine 1991;19:471-6.
Guthrie 2005 {published data only}
Guthrie SO, Lynn C, Lafleur BJ, Donn SM, Walsh WF. A crossover analysis of mandatory minute ventilation compared to synchronized intermittent mandatory ventilation in neonates. Journal of Perinatology 2005;25:643-6.
Herrera 2002 {published data only}
Herrera CM, Gerhardt T, Claure N, Everett R, Musante G, Thomas C, Bancalari E. Effects of volume-guaranteed synchronized intermittent mandatory ventilation in preterm infants recovering from respiratory failure. Pediatrics 2002;110:529-33.
Hird 1990a {published data only}
Hird MF, Greenough A. Causes of failure of neonatal patient triggered ventilation. Early Human Development 1990;23:101-8.
Hird 1990b {published data only}
Hird MF, Greenough A. Gestational age: an important influence on the success of patient triggered ventilation. Clinical Physics and Physiological Measurement 1990;11:307-12.
Hird 1991a {published data only}
Hird MF, Greenough A. Randomised trial of patient triggered ventilation versus high frequency positive pressure ventilation in acute respiratory distress. Journal of Perinatal Medicine 1991;19:379-84 (listed in Wallach EE (ed) Current Opinion in Obstetrics & Gynecology, February 1993).
Hird 1991b {published data only}
Hird MF, Greenough A. Patient triggered ventilation in chronically ventilator-dependent infants. European Journal of Pediatrics 1991;150:732-4.
Hird 1991c {published data only}
Hird MF, Greenough A. Patient triggered ventilation using a flow triggered system. Archives of Disease in Childhood 1991;66:1140-3.
Hird 1991d {published data only}
Hird MF, Greenough A. Comparison of triggering systems for neonatal patient triggered ventilation. Archives of Disease in Childhood 1991;66:426-8 (abstracted in Clinical Digest Series - Pediatrics/Neonatology, Northbrook IL, USA).
Hummler 1996 {published data only}
Hummler H, Gerhardt T, Gonzalez A, Claure N, Everett R, Bancalari E. Influence of different methods of synchronized mechanical ventilation on ventilation, gas exchange, patient effort and blood pressure fluctuations in premature neonates. Pediatric Pulmonology 1996;22:305-13.
Hummler 1997 {published data only}
Hummler H, Gerhardt T, Gonzalez A, Claure N, Everett R, Bancalari E. Increased incidence of sighs (augmented inspiratory eforts) during synchronized intermittent mandatory ventilation (SIMV) in preterm neonates. Pediatric Pulmonology 1997;24:195-203.
Hummler 2006 {published data only}
Hummler H, Engelmann A, Pohlandt F, Franz AR. Volume-controlled intermittent mandatory ventilation in preterm infants with hypoxemic episodes. Intensive Care Medicine 2006;32:577-84.
Jaber 2005 {published data only}
Jaber S, Delay JM, Matecki S, Sebbane M, Eledjam JJ, Brochard L. Volume-guaranteed pressure-support ventilation facing acute changes in ventilatory demand. Intensive Care Medicine 2005;31:1181-8.
Jarreau 1996 {published data only}
Jarreau P-H, Moriette G, Mussat P, Mariette C, Mohanna A, Harf A, Lorino H. Patient-triggered ventilation decreases the work of breathing in neonates. American Journal of Respiratory and Critical Care Medicine 1996;153:1176-81.
John 1994 {published data only}
John J, Bjîrklung LJ, Svenningsen NW, Jonson B. Airway and body surface sensors for triggering in neonatal ventilation. Acta Paediatrica 1994;83:903-9.
Kapasi 1999 {published data only}
Kapasi M, Fujino Y, Kirmse M et al. Effort and work of breathing in neonates during assisted patient triggered ventilation. Pediatric Research 1999;45:306A.
Keszler 2004 {published data only}
Keszler M, Abubakar K. Volume guarantee: stability of tidal volume and incidence of hypocarbia. Pediatric Pulmonology 2004;38:240-5.
Laubscher 1997 {published data only}
Laubscher B Greenough A, Kavadia V. Comparison of body surface and airway triggered ventilation in extremely premature infants. Acta Paediatrica 1997;86:102-4.
Lista 2006 {published data only}
Lista G, Castoldi F, Fontana P, Reali R, Reggiani A, Bianchi S, Compagnoni G. Lung inflammation in preterm infants with respiratory distress syndrome: effects of ventilation with different tidal volumes. Pediatric Pulmonology 2006;41:357-63.
Luyt 2001 {published data only}
Luyt K, Wright D, Baumer JH. Randomised study comparing extent of hypocarbia in preterm infants during conventional and patient triggered ventilation. Archives of Disease in Childhood. Fetal and Neonatal edition 2001;84:F14-7.
Migliori 2003 {published data only}
Migliori C, Cavazza A, Motta M, Chirico G. Effect on respiratory function of pressure support ventilation versus synchronised intermittent mandatory ventilation in preterm infants. Pediatric Pulmonology 2003;35:364-7.
Mitchell 1989 {published data only}
Mitchell A, Greenough A, Hird MF. Limitations of neonatal patient triggered ventilation. Archives of Disease in Childhood 1989;64:924-9.
Mizuno 1994a {published data only}
Mizuno K, Takeuchi T, Itabashi K, Okuyama K. Efficacy of synchronized IMV on weaning neonates from the ventilator. Acta Paediatrica Japonica 1994;36:162-6.
Mizuno 1994b {published data only}
Mizuno K, Kako Y, Ito H, Hasegawa M, Endo T, Imai Y, Hayashi T, Takeuchi T, Itabashi K, Okuyama K. Efficacy of abdominal expansion triggered synchronized IMV in newborns. J Jap Neonat Assoc 1994;30:278.
Moretti 1999 {published data only}
Moretti C, Gizzi C, Papoff P, Lampariello S, Capoferri M, Calcagnini G, Bucci G. Comparing the effects of nasal synchronized intermittent positive pressure ventilation (nSIPPV) and nasal continuous positive airway pressure (nCPAP) after extubation in very low birth weight infants. Early Human Development 1999;56:167-77.
Mrozek 2000 {published data only}
Mrozek JD, Bendel-Stenzel EM, Meyers PA, Bing DR, Connett JE, Mammel MC. Randomized controlled trial of volume-targeted synchronized ventilation and conventional intermittent mandatory ventilation following initial exogenous surfactant therapy. Pediatric Pulmonology 2000;29:11-8.
Nafday 2005 {published data only}
Nafday SM, Green RS, Lin J, Brion LP, Ochshorn I, Holzman IR. Is there an advantage of using pressure support ventilation with volume guarantee in the initial management of preterm infants with respiratory distress syndrome? A pilot study. Journal of Perinatology 2005;25:193-7.
Nakae 1998 {published data only}
Nakae Y, Yamakage M, Horikawa D, Aimono M, Tamiya K, Namiki A. Triggering delay time and work of breathing in three paediatric patient triggered ventilators. Canadian Journal of Anaesthesia 1998;45:261-5.
Nikischin 1996 {published data only}
Nikischin W, Gerhardt T, Everett R, Gonzalez A, Hummler H, Bancalari E. Patient triggered ventilation: a comparison of tidal volume and chest wall and abdominal motion as trigger signals. Pediatric Pulmonology 1996;22:28-34.
Nishimura 1995 {published data only}
Nishimura M, Hess D, Kacmarek RM. The response of flow-triggered infant ventilators. American Journal of Respiratory and Critical Care Medicine 1995;152:1901-9.
Olsen 2002 {published data only}
Olsen SL, Thibeault DW, Truog WE. Crossover trial comparing pressure support with synchronized intermittent mandatory ventilation. Journal of Perinatology 2002;22:461-6.
Osorio 2005 {published data only}
Osorio W, Claure N, D'Ugard C, Athavale K, Bancalari E. Effects of pressure support during an acute reduction of synchronized intermittent mandatory ventilation in preterm infants. Journal of Perinatology 2005;25:412-6.
Polimeni 2006 {published data only}
Polimeni V, Claure N, D'Ugard C, Bancalari E. Effects of volume-targeted synchronized intermittent mandatory ventilation on spontaneous episodes of hypoxemia in preterm infants. Biology of the Neonate 2006;89:50-5.
Servant 1992 {published data only}
Servant GM, Nicks JJ, Donn SM, Bandy KP, Lathrop C, Dechert RE. Feasibility of applying flow-synchronized ventilation to very low birthweight infants. Respiratory Care 1992;37:249-53.
Smith 1997 {published data only}
Smith KM, Walig TM, Bing DR, Georgieff MK, Boros SJ, Mammel MC. Lower respiratory rates without decreases in oxygen consumption during neonatal synchronized intermittent mandatory ventilation. Intensive Care Medicine 1997;23:463-8.
Takeuchi 1994 {published data only}
Takeuchi MK, Itabashi K, Okuyama K. Efficacy of synchronized IMV on weaning neonates from the ventilator. Acta Paediatrica Japonica 1994;36:162-6.
Tanaka 1995 {published data only}
Tanaka D, Takeuchi T, Kako Y, Imai Y, Hayashi T, Itahashi K, Okuyama K. The energy expenditure of the newborn infants during SIMV. J Jap Neonat Assoc 1995;31:333.
Thiagarajan 2004 {published data only}
Thiagarajan RR, Coleman DM, Bratton SL, Watson RS, Martin LD. Inspiratory work of breathing is not decreased by flow-triggered sensing during spontaneous breathing in children receiving mechanical ventilation: a preliminary report. Pediatric Critical Care Medicine 2004;5:375-8.
Upton 1990 {published data only}
Upton CJ, Milner AD, Stokes GM. The effect of changes in inspiratory time on neonatal triggered ventilation. European Journal of Pediatrics 1990;149:648-50.
Vishveshwara 1991 {published data only}
Vishveshwara N, Freeman B, Peck M, Caliwag N, Shook S, Rajani KB. Patient triggered synchronized assisted ventilation of newborns: report of a preliminary study and three years' experience. Journal of Perinatology 1991;11:347-54.
* indicates the primary reference for the study
Greenough A, Milner AD, Dimitriou G. Synchronized mechanical ventilation for respiratory support in newborn infants. In: Cochrane Database of Systematic Reviews, Issue 1, 1998.
Greenough A, Milner AD, Dimitriou G. Synchronized mechanical ventilation for respiratory support in newborn infants. In: Cochrane Database of Systematic Reviews, Issue 1, 2001.
Greenough A, Milner AD, Dimitriou G. Synchronized mechanical ventilation for respiratory support in newborn infants. In: Cochrane Database of Systematic Reviews, Issue 3, 2004.
Comparison or outcome | Studies | Participants | Statistical method | Effect size |
---|---|---|---|---|
01 HFPPV vs CMV | ||||
01 Death | 3 | 585 | RR (fixed), 95% CI | 0.80 [0.62, 1.03] |
02 Air leaks | RR (fixed), 95% CI | Subtotals only | ||
03 BPD (oxygen dependency at 28 days) | 3 | 585 | RR (fixed), 95% CI | 1.09 [0.78, 1.51] |
02 ACV / SIMV vs CMV | ||||
01 Death | 5 | 1729 | RR (fixed), 95% CI | 1.19 [0.95, 1.49] |
02 Airleaks | 6 | 1769 | RR (fixed), 95% CI | 1.03 [0.80, 1.34] |
03 Duration of ventilation (hours) | 4 | 1402 | WMD (fixed), 95% CI | -34.78 [-62.11, -7.44] |
04 Extubation failure | 4 | 1056 | RR (fixed), 95% CI | 0.93 [0.68, 1.28] |
05 Severe IVH | 5 | 1729 | RR (fixed), 95% CI | 1.03 [0.74, 1.43] |
06 BPD (oxygen dependency at 28 days) | 4 | 805 | RR (fixed), 95% CI | 0.91 [0.75, 1.12] |
07 Moderate/Severe BPD (oxygen dependent at 36 weeks PCA) | 2 | 1310 | RR (fixed), 95% CI | 0.90 [0.75, 1.08] |
03 ACV or PRVCV vs SIMV | ||||
01 Duration of weaning (hours) | 3 | 120 | WMD (fixed), 95% CI | -42.38 [-94.35, 9.60] |
02 Weaning failure | 3 | 120 | RR (fixed), 95% CI | 0.78 [0.31, 1.93] |
03 Extubation failure | 3 | 120 | RR (fixed), 95% CI | 1.00 [0.37, 2.67] |
04 Air leaks | 3 | 120 | RR (fixed), 95% CI | 0.80 [0.23, 2.83] |
05 Death | 1 | 211 | RR (fixed), 95% CI | 1.03 [0.50, 2.11] |
06 Severe IVH (grade III and IV) | 1 | 203 | RR (fixed), 95% CI | 0.67 [0.29, 1.58] |
07 Moderate/Severe BPD | 1 | 185 | RR (fixed), 95% CI | 0.83 [0.55, 1.27] |
04 PS + SIMV versus SIMV | ||||
01 Death | 2 | 214 | RR (fixed), 95% CI | 0.68 [0.29, 1.59] |
02 Air leaks | RR (fixed), 95% CI | Subtotals only | ||
03 BPD | 2 | 214 | RR (fixed), 95% CI | 0.91 [0.74, 1.12] |
04 Severe IVH (grade III and IV) | 1 | 107 | RR (fixed), 95% CI | 0.92 [0.41, 2.08] |
01 HFPPV vs CMV
01.02.01 Pneumothorax
01.02.02 Pulmonary interstitial emphysema
01.03 BPD (oxygen dependency at 28 days)
02 ACV / SIMV vs CMV
02.03 Duration of ventilation (hours)
02.06 BPD (oxygen dependency at 28 days)
02.07 Moderate/Severe BPD (oxygen dependent at 36 weeks PCA)
03 ACV or PRVCV vs SIMV
03.01 Duration of weaning (hours)
03.04.01 Total air leaks
03.05.01 Death prior to discharge
03.06 Severe IVH (grade III and IV)
03.07.01 Moderate/Severe BPD (oxygen dependency in survivors at 36 weeks PMA)
04 PS + SIMV versus SIMV
04.01.01 Death during first 28 days
04.01.02 Death prior to discharge
04.02.01 Pneumothorax
04.02.02 Pulmonary interstitial emphysema
04.03.01 BPD (oxygen dependency at 28 days)
04.03.02 Moderate/Severe BPD (oxygen dependency at 36 weeks PMA)
04.04 Severe IVH (grade III and IV)
Prof Anthony D Milner
Emeritus Professor of Neonatology
Department of Child Health
King's College London School of Medicine and Dentistry
Neonatal Intensive Care Unit
King's College London School of Medicine
Bessemer Road
London UK
SE5 9RS
Telephone 1: 0044 20 3299 3037
Facsimile: 0044 20 3299 8284
E-mail: anthony.milner@kcl.ac.uk
Michael Prendergast
UCLA Drug Abuse Research Center
Neuropsychiatric Institute, University of California
11050 Santa Monica Blvd, Suite 150, Los Angeles, CA 90025
Los Angeles
California USA
90025
E-mail: mlp@ucla.edu
This review is published as a Cochrane review in The Cochrane Library, Issue 1, 2008 (see http://www.thecochranelibrary.com for information). Cochrane reviews are regularly updated as new evidence emerges and in response to feedback. The Cochrane Library should be consulted for the most recent version of the review. |