Inversed ratio ventilation as an rescue option for ventilation of very premature infants

Objective: We report on three very premature infants who were treated with inverse ratio ventilation (IRV) using a high ventilation frequency (˜60/min) as a rescue method for oxygenation. IRV has become a popular mode of ventilation in adults, but has not been used in premature infants so far. The idea of using IRV stems from a concern of possible ventilator-induced lung injury using high peak pressures to generate higher mean inspiration pressures. Using IRV creates the possibility to increase tidal volumes, overcome the critical opening pressure during inspiration and better alveolar recruitment without increa…