1. Technical Limitations: The effectiveness of VTV relies heavily on the accuracy of the ventilator's monitoring and adjustment capabilities. Inaccurate measurements can lead to inappropriate ventilation. 2. Neonatal Variability: Neonates have rapidly changing lung mechanics, making it challenging to maintain the preset tidal volumes consistently. 3. Training and Expertise: Effective use of VTV requires specialized training for healthcare providers to understand and manage the settings correctly.