Combined oscillatory and mandatory ventilation in newborn infants

Infants who fail to respond to intermittent mandatory ventilation (IMV) and/or high frequency oscillatory ventilation (HFOV) alone, can benefit from a combination of HFOV and IMV known as combined oscillatory and mandatory ventilation (COMV). This article reviews the available evidence on the effectiveness and safety of COMV, including animals studies. The author's experience of the effect of COMV in both preterm and term infants who did not respond to IMV or HFO is described and operational guidance regarding management of COMV is given.