Predictable normocapnia [correction of normocapnoea] in controlled ventilation of infants with Jackson Rees or Bain system.

Abstract

We have devised a formula for ventilator settings which provide normal minute ventilation without rebreathing during controlled ventilation using a Jackson Rees or Bain system. As VT = VS + VF- VL, where VT = delivered tidal volume, VS = set tidal volume, VF = the volume of fresh gas entering during the inspiratory phase and VL = the lost volume due to the compliance of the system, VS was derived: VS = VL + VT x [1-b/(1 + a)] where a = expiratory-to-inspiratory ratio and b = the ratio of fresh gas flow to the minute ventilation. It was evaluated in 62 infants. Arterial partial pressure of carbon dioxide (mean (SD)) was 4.6 (0.5) kPa (35 (4) mmHg) with a range of 3.42-5.78 kPa (26-44 mmHg). The 90th percentile was 5.1 kPa (39 mmHg). It is concluded that predictable normocapnia [corrected] can be conveniently achieved in infants in controlled ventilation with Jackson Rees or Bain system if our formula is applied.