Short-term physiological effects of pressure rise time modulation during volume-guaranteed neonatal ventilation
摘要
Pressure rise time (PRT) is an adjustable ventilator parameter that regulates the rate of inspiratory flow delivery and may influence ventilator mechanics and tissue oxygenation. However, its short-term physiological effects in neonates receiving volume-targeted ventilation remain incompletely characterized. Seventeen hemodynamically stable neonates receiving assist-control volume guarantee (AC-VG) and pressure support volume guarantee (PSV-VG) ventilation were studied using three different PRT settings (0.10, 0.20, and 0.30 s), each applied for 20-minute periods. Ventilator parameters, peripheral oxygen saturation (SpO₂), and cerebral regional oxygen saturation (CrSO₂) measured by near-infrared spectroscopy (NIRS) were continuously monitored. During AC-VG ventilation, modulation of PRT did not result in significant changes in ventilator parameters or oxygenation. During PSV-VG ventilation, peak inspiratory pressure increased with longer PRTs, while mean airway pressure, SpO₂, and CrSO₂ remained unchanged. In this short-term physiological study, modulation of pressure rise time influenced selected ventilator mechanics without producing significant changes in peripheral or cerebral oxygenation under stable clinical conditions. Larger prospective studies incorporating longer observation periods and clinically relevant outcomes are required to further define the role of pressure rise time adjustment in neonatal mechanical ventilation.
Trial registration: This study was retrospectively registered at ClinicalTrials.gov (Identifier NCT07465237).