Work of breathing at different tidal volume targets in newborn infants with congenital diaphragmatic hernia.

Summary

This small randomised crossover study examined work of breathing, measured by the diaphragmatic pressure-time product, at three volume-targeted ventilation levels (4, 5 and 6 ml/kg) in nine term infants after surgical repair of congenital diaphragmatic hernia. Work of breathing was higher at 4 ml/kg than at 5 or 6 ml/kg. The authors suggest the lowest target should be avoided in post-surgical CDH infants despite pulmonary hypoplasia. It is relevant to lung-protective ventilation strategies in neonatal surgical intensive care.

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