The use of breathing machines that match their output with the breathing effort of the baby (that is, they synchronize their output to a baby's spontaneous effort) is standard care in industrialized countries. Both the level of airflow generated by the baby during a breath ('flow-cycling') and the baby's intention to take a breath ('time-cycling') can be used for synchronization. Theoretically, flow-cycling allows for better synchronization because it synchronizes not only the beginning but also the duration of a breath. The main aim of this review was to find out whether flow-cycled compared to time-cycled synchronized ventilation offers advantages for babies requiring assisted ventilation.
Only two small short-term studies on a total of 19 preterm babies were identified in this review. These studies did not report on important outcomes such as the frequency of long lasting breathing disorders. Therefore, there is insufficient evidence to decide whether flow-cycled, compared to time-cycled synchronized ventilation offers advantages for babies who need assisted ventilation.