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Ericksen K, Alpan G, La Gamma EF. Effect of ventilator modes on neonatal cerebral and peripheral oxygenation using near infrared spectroscopy. Acta Paediatr. 2020 Sep 28. doi: 10.1111/apa.15600. Epub ahead of print. PMID: 32989810.

Aim: The effect of ventilator modes on regional tissue oxygenation in premature neonates with respiratory distress syndrome (RDS) has yet to be delineated. Previous studies have looked at global oxygen delivery and have not assessed the effects on regional tissue oxygenation. Our aim in this study was to assess such tissue oxygenation in premature babies with RDS in relation to differing modes of ventilation using near infrared spectroscopy (NIRS).

Methods: In 24 stable preterm infants with RDS, undergoing elective wean in ventilator mode, cerebral and muscle tissue oxygenation were assessed using NIRS. Infants were weaned from high frequency oscillator or jet ventilator to conventional invasive ventilation (CV), or extubated from CV to noninvasive mechanical ventilation. Data at 30 minutes prior and at one hour after change in ventilator mode were compared (paired t-test).

Results: In babies changed from high frequency oscillation to CV, jet to CV, and CV to noninvasive ventilation, the differences in cerebral NIRS (mean ± sd) were 1.7±9.9%, 2.3±5.7%, and 2.1±8.4% respectively. The concomitant changes in muscle NIRS were -2.9±8.5%, 8.1±9.7%, and 3.6±22.4% respectively. No changes were statistically significant.

Conclusion: Our data suggests that there is no alteration in regional tissue oxygenation related to ventilator mode in stable preterm infants with improving RDS.

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