1.Volume guaranteed (VG) provides automatic adjustment of the peak inspiratory pressure for ensuring a minimum set tidal volume.
The flow sensor of the ventilator should calibrated before starting VG ventilation. We set VT of 3.5-4 ml/kg for infants >1000 g and 5 ml/kg <1000 g. During SIMV/SIPPV/PSV + VG, all ventilator settings are the same, only the PIP limit sets 10 cm H2O above the PIP that is used during the conventional SIMV mode.
At the follow-up, the set VT is adjusted according to the arterial blood gas analysis.
2. The leak is very important during VG ventilation, no more than 40%; higher leak results in erroneous measurement of delivered VTe (expire) and lead to a discrepancy between set VT and delivered VT.
Best regards.
