Volume-controlled ventilation for severe neonatal respiratory failure.

Volume-controlled ventilation was utilized as a rescue modality in six newborn infants with severe respiratory failure. Infants were switched from time-cycled, pressure-limited ventilation to volume-controlled ventilation at 10-12 mL/kg using the VIP-Bird infant ventilator. All six displayed dramatic improvements in oxygenation with virtually no change in mean airway pressure and with subsequent resolution of the respiratory failure. Preliminary analysis of pulmonary function during volume-controlled ventilation suggests differences in the patterns of delivery of tidal volume and minute ventilation, which are more consistent. This may improve stabilization of lung volume and decrease ventilation-perfusion mismatch.