Randomised weaning trial comparing assist control to pressure support ventilation

Abstract

Objectives: To determine if the work of breathing was lower, respiratory muscle strength greater, but the degree of asynchrony higher during weaning by assist control ventilation (ACV) rather than pressure support ventilation (PSV) and if any differences were associated with a shorter duration of weaning.

Design: Randomised trial

Setting: Tertiary neonatal unit

Patients: Thirty-six infants, median gestational age 29 (range 24 to 39) weeks

Intervention: Weaning by either ACV or PSV.

Main outcome measures: At baseline, 24 hours after entering the study and immediately prior to extubation, the work of breathing (PTPdi), thoracoabdominal asynchrony (TAA) and respiratory muscle strength (Pimax) were assessed and weaning duration recorded.

Results: There were no significant differences in the median PTPdi, TAA and Pimax results at any time point. The inflation times during ACV and PSV were similar. The median duration of weaning was 34 (range 7-100) hours in the ACV group and 27 (range 10-169) hours in the PSV group (p=0.88).

Conclusion: No significant differences were found between weaning by PSV and ACV when similar inflation times were used.