Persistent pulmonary hypertension of the newborn is a serious and life-threatening condition characterized by sustained elevation of pulmonary vascular resistance leading to right-to-left shunting and severe hypoxemia in neonates Effective management often requires advanced ventilatory support to optimize oxygenation and reduce pulmonary vascular pressures.
Mechanical ventilation strategies in neonates with PPHN aim to achieve adequate gas exchange while minimizing ventilator-induced lung injury . Conventional modes such as pressure-controlled ventilation and volume-controlled ventilation have limitations: Pressure-controlled ventilation provides consistent airway pressures but variable tidal volumes, while volume-controlled ventilation delivers stable tidal volumes but may generate injurious peak inspiratory pressures particularly in non-homogeneous lungs.
Pressure-Regulated Volume Control is a dual-control ventilation mode that combines the advantages of Pressure-controlled ventilation and Volume Control ventilation by adjusting inspiratory pressures to achieve a set target tidal volume while maintaining the lowest possible airway pressures . This adaptive mode potentially enhances patient-ventilator synchrony, reduces barotrauma and volutrauma and optimizes oxygen delivery in fragile neonatal lungs This study aims to assess the clinical and respiratory outcomes of Pressure-Regulated Volume Control ventilation as compared with patient on pressure-controlled ventilation in neonates with persistent pulmonary hypertension.
