automatic regulation of peak pressure during high frequency ventilation Invasive ventilation in preterm infants
Conditions
Interventions
When postnatal consent is retrieved from the legal gardians as soon as possible 
after birth and the preterm infant fails non-invasive respiratory support the 
patient will be endotracheally intubated following local existing respiratory 
protocols. Next, HFV will be initiated and after on-line randomisation the 
patient will be ventilated used our current protocol with HFV without VG or 
when randomized to the intervention with HFV with VG with VG set between 1-3 
ml/kg resulting in normal (Tc)PCO2.
Sponsors
Academisch Medisch Centrum
Eligibility
Inclusion criteria
Inclusion criteria: - preterm born between 24 weeks 0 days and 29 weeks 6 days post menstrual age - failng non-invasive respiratory support and needs endotracheal intubation for invasive support - The infant has a parent or other legally acceptable representative capable of understanding the informed consent document and can provide consent on the participant behalf.
Exclusion criteria
Exclusion criteria: - The infant has known congenital malformations - The infant is born after a pregnancy with premature rupture of membranes < 22 weeks with anhydramnion or fetal hydrops - Refusal of informed consent - The infant does not have a guardian who can provide informed consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| - Incidence of bronchopulmonary dysplasia defined as respiratory support and oxygen need at 36 weeks gestation age in preterm infants <= 29 weeks of gestation - Carbon dioxide stability defined as percentage of time within the target range CO2 (5-8 kPa) | — |
Secondary
| Measure | Time frame |
|---|---|
| - Changes in pressure or DCO2 during OLV with VG in relation to carbon dioxide - Duration of invasive ventilation - Intracerebral findings at 36 weeks of gestation - Effect of VG during standard of care like endotracheal suctioning or endotracheal surfactant administration. | — |
Countries
Netherlands
Outcome results
None listed