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. 2017 Oct 17;2017(10):CD003666. doi: 10.1002/14651858.CD003666.pub4

Chowdhury 2013.

Methods Single‐centre randomised trial.
Participants 40 infants.
Inclusion criteria: < 34 weeks GA, mechanically ventilated in the first week after birth.
Exclusion criteria: major congenital anomalies, ventilated > 24 h or supported by high‐frequency ventilation or both.
Interventions Ventilator: SLE5000 (software 4,3). Both groups: inflation time 0.3‐0.4 sec, inflation rate 40‐60/min, PEEP not reported.
  • VTV group (n = 20): SIMV + TTV at 5 mL/kg.

  • PLV group (n = 20): SIMV.


Both groups: predefined weaning strategy; underlying trigger mode changed from SIMV to AC.
Duration of intervention: until extubation.
Outcomes Primary: time to reach specified weaning criteria.
Other: survival to discharge, BPD at 28 days, IVH grade 3 or 4, cystic PVL, PDA treated (medication/ligation), pneumothorax, postnatal steroids, duration of ventilation, failure of initial ventilation mode, blood gas analyses and work of breathing (assessed by transdiaphragmatic pressure time product).
Supplemental data Mortality, BPD at 36 weeks, detailed blood gas, duration of ventilation presented as mean (SD).
Notes Imbalance with regard to BW, GA and antenatal steroid use despite randomisation.
Participants in the PLV group had lower median GA/BW than participants in the VTV group (median GA/BW 26 weeks/856 g vs 28 weeks/1016 g). In the published report, authors adjusted for this difference, but this review used the unadjusted outcomes.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Random number table generation.
Allocation concealment (selection bias) Low risk Blinding of randomisation: sealed opaque envelopes.
Blinding of participants and personnel (performance bias) 
 All outcomes High risk No.
Blinding of outcome assessment (detection bias) 
 All outcomes High risk No.
Intervention bias (strict vs hybrid studies) Low risk Not applicable.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Follow‐up: complete to end of intervention. Secondary postintervention outcomes reported during period of primary admission.
Selective reporting (reporting bias) Unclear risk Trial registration submitted after completion of study.
Other bias High risk Despite randomisation, there was imbalance with regard to BW, GA and antenatal steroid use. Participants in the PLV group had lower median GA/BW than participants in the VTV group (median GA/BW 26 weeks/856 g vs 28 weeks/1016 g).