Mechanical Ventilation of the Neonate: Should We Target Volume or Pressure?

For more than 40 years conventional mechanical ventilation has been used for the treatment of neonatal respiratory failure. Until relatively recently, this was accomplished with time-cycled pressure-limited ventilation, using intermittent mandatory ventilation. Earlier attempts at volume-targeted ventilation were largely ineffective because of technological limitations. The advent of microprocessor-based devices gives the clinician an option to choose either target variable to treat neonatal patients. This paper reviews the principles of each and the accumulated evidence.