Factors associated with initial tidal volume selection during neonatal volume-targeted ventilation in two NICUs: a retrospective cohort study

Objective: To quantify initial tidal volume (VT) during neonatal volume-targeted ventilation (VTV) and to characterize the agreement of initial VT with the limited-evidence available. Study design: We performed a multi-center retrospective observational cohort study in two Neonatal Intensive Care Units evaluating 313 infants who received VTV as the initial ventilation modality prior to postnatal day 14. We generated descriptive statistics and performed multivariable logistic regression analysis to determine factors associated with initial VT use that agreed with available literature. Results: 154 (49%) infants received an initial VT of 5.0 mL/kg (median 5.0 mL/kg, IQR 5.0–5.1). 45 (14%) infants received an initial VT that was congruent with available literature. A birth weight of 700 –<1250 g was significantly associated with an initial VT in agreement with VT literature (aOR 9.4, 95% CI 1.7–50.4). Conclusions: Most infants receive an initial VT of 5.0 mL/kg.