Performance and safety of volume guarantee ventilation in neonates using the fabian ventilator, a multicenter study.

Objective: To evaluate the performance (i.e., agreement between set and measured parameters) and safety (adverse events, device malfunctions, and ventilator alarms) of the fabian HFOi neonatal ventilator in volume guaranteed (VG) mode during conventional ventilation.

Stabilization, respiratory care and survival of extremely low birth weight infants transferred on the first day of life.

Objective: To assess stabilization, respiratory care and survival of extremely low birth weight (ELBW, <1000 g at birth) infants requiring emergency transfer to tertiary NICUs on the first day of life.

Study Design: Retrospective cohort study of 55 ELBW infants transported by a dedicated neonatal transport service over a 65-month period. Ventilator data were downloaded computationally.

Detection and quantitative analysis of patient-ventilator interactions in ventilated infants by deep learning networks.

Background: The study of patient-ventilator interactions (PVI) in mechanically ventilated neonates is limited by the lack of unified PVI definitions and tools to perform large scale analyses.

Methods: An observational study was conducted in 23 babies randomly selected from 170 neonates who were ventilated with SIPPV-VG, SIMV-VG or PSV-VG mode for at least 12 h. 500 breaths were randomly selected and manually annotated from each recording to train convolutional neural network (CNN) models for PVI classification.

Particular genomic and virulence traits associated with preterm infant-derived toxigenic Clostridium perfringens strains.

Clostridium perfringens is an anaerobic toxin-producing bacterium associated with intestinal diseases, particularly in neonatal humans and animals. Infant gut microbiome studies have recently indicated a link between C. perfringens and the preterm infant disease necrotizing enterocolitis (NEC), with specific NEC cases associated with overabundant C.

Comparison of flexible nasogastric tube and semi-rigid catheter during less invasive surfactant administration.

Background: Various flexible and semi-rigid catheter techniques have been reported for surfactant delivery during less invasive surfactant administration (LISA) in preterm infants. Data on the effect of catheter selection on procedural success rates and adverse events are limited. Our objective was to compare the rates of success and adverse events of LISA performed with nasogastric tube and semi-rigid catheter.

Synchronized intermittent mandatory ventilation with volume guarantee and pressure support in neonates: Detailed analysis of ventilator parameters.

Objective: To analyse the relationship between peak inflating pressure, expired tidal volume, respiratory rate, and inspiratory time of volume-guaranteed ventilator inflations and pressure-supported spontaneous breaths during synchronized intermittent positive pressure mode with volume guarantee and pressure support (SIMV-VG-PS) in neonates.

Methods: Ventilator parameters were downloaded every second from 16 babies ventilated with SIMV-VG-PS mode using Dräger Babylog VN500 ventilators over 137 days. Transcutaneous carbon dioxide (tcCO ) data were also collected.

Acceleration during neonatal transport and its impact on mechanical ventilation.

Objective: During interhospital transfer, critically ill neonates frequently require mechanical ventilation and are exposed to physical forces related to movement of the ambulance. In an observational study, we investigated acceleration during emergency transfers and if they result from changes in ambulance speed and direction or from vibration due to road conditions. We also studied how these forces impact on performance of the fabian+nCPAP evolution neonatal ventilator and on patient-ventilator interactions.

Incidence, predictors of success and outcome of LISA in very preterm infants.

Objectives: The aim of this study was to examine the success rate of less invasive surfactant administration (LISA), to identify early predictive factors for the outcome of LISA, and to compare neonatal outcomes between the LISA failure group and the group of infants who were successfully treated with LISA.

Design: A retrospective cohort study.

Patients: Infants born at less than 33 weeks of gestation (n = 158) and treated with LISA for respiratory distress syndrome.

Volume-Targeted Ventilation.

Volume-targeted ventilation (VTV) has been increasingly used in neonatology. In systematic reviews, VTV has been shown to reduce the risk of neonatal morbidities and improve long-term outcomes. It is adaptive ventilation using complex computer algorithms to deliver ventilator inflations with expired tidal volumes close to a target set by clinicians.

Computational analysis of neonatal ventilator waveforms and loops.

Background: Modern neonatal ventilators allow the downloading of their data with a high sampling rate. We wanted to develop an algorithm that automatically recognises and characterises ventilator inflations from ventilator pressure and flow data.

Methods: We downloaded airway pressure and flow data with 100 Hz sampling rate from Dräger Babylog VN500 ventilators ventilating critically ill infants.

Fifteen-minute consultation: How to interpret and manage ventilator alarms in the neonatal intensive care unit.

Modern neonatal intensive care units use a large number of monitoring and therapeutic devices. Most of them have alarms with varying degree of standardisation. Mechanical ventilator alarms alert clinicians about technical problems with equipment, acute deterioration of the patient, changes in his or her clinical condition or in respiratory mechanics.

Volume guarantee ventilation in neonates treated with hypothermia for hypoxic-ischemic encephalopathy during interhospital transport.

Objective: We investigated if volume guarantee (VG) ventilation in babies with hypoxic-ischemic encephalopathy (HIE) during interhospital transport decreases tidal volumes and prevents hypocapnia.

Study Design: We computationally collected and analyzed ventilator data of babies ventilated with synchronized intermittent mandatory ventilation (SIMV) with VG (n = 28) or without VG (n = 8).

Result: The expiratory tidal volume of ventilator inflations was lower with SIMV-VG (median [IQR]: 4.

Effect of pressure rise time on ventilator parameters and gas exchange during neonatal ventilation.

Background: Pressure rise time (PRT), also known as slope time to the peak inflating pressure can be set on some modern neonatal ventilators. On other ventilators, PRT is determined by the set circuit flow. Changing slope time can affect mean airway pressure (MAP), oxygenation, and carbon dioxide elimination.

Volume Guaranteed Ventilation During Neonatal Transport.

Objectives: To compare tidal volumes, inflating pressures and other ventilator variables of infants receiving synchronized intermitted mandatory ventilation with volume guarantee during emergency neonatal transport with those of infants receiving synchronized intermitted mandatory ventilation without volume guarantee.

Design: Retrospective observational study.

Setting: A regional neonatal emergency transport service.

Volume-targeted ventilation with a Fabian ventilator: maintenance of tidal volumes and blood CO.

Objective: To analyse the performance of the Fabian +NCPAP evolution ventilator during volume guarantee (VG) ventilation in neonates at maintaining the target tidal volume and what tidal and minute volumes are required to maintain normocapnia.

Methods: Clinical and ventilator data were collected and analysed from 83 infants receiving VG ventilation during interhospital transfer. Sedation was used in 26 cases.

Flow cytometry for near-patient testing in premature neonates reveals variation in platelet function: a novel approach to guide platelet transfusion.

Background: Neonatal haemorrhaging is often co-observed with thrombocytopenia; however, no evidence of a causal relationship with low platelet count has been reported. Regardless, the administration of a platelet transfusion is often based upon this parameter. Accurate measurement of platelet function in small volumes of adult blood samples by flow cytometry is well established and we propose that the use of the same technology could provide complementary information to guide the administration of platelet transfusions in premature neonates.

Analysis of peak inflating pressure and inflating pressure limit during neonatal volume guaranteed ventilation.

Objectives: To report how peak inflating pressure (PIP), tidal volume (VT) and low-tidal volume alarms are affected by maximum allowed inflating pressure (P) during volume guarantee (VG) ventilation.

Study Design: Ventilation data were analysed with 1 Hz sampling rate from 25 neonates receiving synchronised intermittent positive pressure ventilation with VG for >12 h.

Results: The difference between P and PIP (P) ranged between 5 and 20 mbar (median = 11 mbar) despite a protocol to keep P 5 mbar above the "working PIP".

High-frequency oscillatory ventilation with volume guarantee: a single-centre experience.

Objective: High-frequency oscillatory ventilation (HFOV) is widely used in neonatology. The Dräger Babylog VN500 ventilator offers volume-guaranteed HFOV (HFOV-VG) mode when the high-frequency tidal volume (VThf) to be delivered can be set. We investigated how HFOV-VG maintains VThf in the short and longer term and how it affects other ventilator parameters and blood gases.

Leak Compensation During Volume Guarantee With the Dräger Babylog VN500 Neonatal Ventilator.

Objectives: To investigate how compensating for endotracheal tube leaks by targeting the leak-compensated tidal volume affects measured physiologic and ventilator variables during neonatal mechanical ventilation.

Design: Retrospective observational study.

Setting: A level III Neonatal ICU.