Artificial ventilation in severe IRDS using inspiratory plateau, prolonged expiratory time and low frequency.

57 preterm and 1 term infant suffering from severe idiopathic respiratory distress syndrome with respiratory insufficiency were mechanically ventilated with an inspiratory-time of at least 1.5 sec and an inspiratory:expiratory ratio of always less than 1:2. Consequently the respiratory frequencies were below 14/min (low frequency ventilation). The infants were allowed to breathe spontaneously during the expiratory phase of the respirator. Applying these conditions we achieved satisfactory oxygenation and control of PCO2 elevation in our patients. 34 infants (59%) survived. None showed radiological evidence of bronchopulmonary dysplasia. This fact together with a relatively low incidence of pneumothorax (6.8%) suggests that this method if compared with conventional ventilation is less likely to cause persistent lung damage.