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Mechanical Ventilation of the Newborn Clinical Gate Home Account Register-org Log In Lost Password Subscriptions ABOUT Contact us Recent Posts Presurgical Functional MappingAndrew C Papanicolaou Roozbeh Rezaie Shalini Narayana Marina Kilintari Asim F Choudhri Frederick A Boop and James W Wheless Child With SeizureDon K Mathew Lawrence D Morton Pharmacologic Consequences SeizuresShilpa Kadam Michael V Johnston Self-Limited EpilepsiesDouglas R Nordli Jr Colin Ferrie Chrysostomos P Panayiotopoulos in Epilepsy Network Neurodevelopmental PerspectiveRaman Sankar Edward Cooper Meta Register Entries RSS Comments WordPress org Categories Allergy Immunology Anesthesiology Basic Science Cardiothoracic Surgery Cardiovascular Complementary Medicine Critical Care Dermatology Emergency Endocrinology Diabetes Metabolism Gastroenterology Hepatology Hematology Oncology Palliative Internal Neonatal Perinatal Nephrology Neurology Neurosurgery Nursing amp Midwifery Medical Assistant Obstetrics Gynecology Opthalmology Orthopaedics Otolaryngology Pathology Pediatrics Physical Rehabilitation Plastic Reconstructive Psychiatry Pulmolory Respiratory Radiology Rheumatology Search Engine Published on by admin Filed under Last modified Print this page Average rate star Your rating none votes Rate it Star Stars label This article have been viewed times Tweet Chapter I nbsp Indications for Generally Fall into Following Severe oxygenation deficit from Intrapulmonary shunting a Meconium aspiration syndrome MAS b Sepsis c pneumonia Intracardiac Patent ductus arteriosus PDA foramen ovale PFO B Ventilatory failure with elevated Pco significant respiratory acidosis perfusion mismatch Apnea associated Prematurity Cold stress d Hypoglycemia e Intraventricular hemorrhage IVH f Drugs Congenital anomalies see Lung hypoplasia Pulmonary agenesis Idiopathic bilateral pulmonary diaphragmatic hernia CDH Abdominal contents occupy thoracic cavity May be left sided right or Tracheal Stenosis Malacia Tracheal-esophageal fistula Cardiac defects Anomalies Any anomaly preventing adequate oxygen delivery Need surfactant administration AARC Practice Guidelines Surfactant Administration deficiency is prematurity Infants born at lt weeks gestation may deficient replacement after meconium decreases function Replacing can effective to improve span II Goals Provide ventilation mm Hg depending underlying lung pathology pH gt Po Spo preterm infants term Promote patient ventilator synchrony Appropriate mode Minimize infant s effort appropriate inspiratory trigger flow rates meet demands Terminate inspiration conjunction desire exhale Avoid air trapping Recruit maintain volume Use positive end-expiratory pressure PEEP Adjust ventilating attain tidal Vt ml kg Assess chest radiography Aim lungs inflated ninth rib bilaterally Deliver controlled concentration III Complications Ventilator-induced disease interstitial emphysema PIE Chronic CLD Hyperoxia Retinopathy ROP Oxygen toxicity Hypocarbia Periventricular leukomalacia PVL Softening white matter around ventricles brain Associated decreased premature alkalosis Decreased cardiac output Increased intrathoracic venous return E Pneumothorax Indiscriminately high Nonhomogeneous compliance Air Pneumonia Organisms introduced during mechanical Bypassed upper airway intubation Inappropriate suctioning technique Contamination caregivers G distention gastric Common bag-mask BMV should vented through oral nasal tube H Ventilator malfunction Loss compressed gas source Electrical power loss Software Circuit disconnect Airway complications Accidental extubation Endotracheal ETT not secure Infant moving Tension circuit obstruction Secretions blocking against wall trachea Kink laryngeal damage pharyngeal tear esophageal Bleeding Trauma Aggressive Esophageal Misplaced Displaced movement repositioning IV Manual Before initiating newborn manual are performed neonate Equipment Non self-inflating bag connected an Self-inflating reservoir device Pressure monitoring size mask attached Position face Cover nares mouth tip chin contact eyes Hold thumb index middle finger rim Keep forward fourth fifth fingers head midline neck slightly extended optimize position Apply gentle downward create seal g Squeeze observe h If no reassess following Mask Head pharynx Mouth opening delivered i Ventilate approximately breaths min j enough k Maintain cm O end expiration Intubation Unlike adult cuffed ETTs generally needed provide neonates The cricoid cartilage narrowest point neonatal Appropriately sized uncuffed reduce tubes Approximate sizes gestational ages weights listed Table – TABLE Suction Catheter Sizes Various Gestational Ages Weights Age wk Weight Size ID French inner diameter Laryngoscope bulbs batteries blade Miller Size-appropriate stylet Resuscitation size-appropriate canister suction regulator Appropriate-sized catheters Tape Scissors Stethoscope Placing Establish use if apneic flat surface Turn laryngoscope light hold hand Slide over side tongue Advance vallecula Lift out way expose area Observe vocal cords necessary view larynx your insert as they open Insert until cord guide level Estimated distance according age weight outlined Distance Lip Tip Properly Inserted Oral Kilogram Centimeter Mark Stabilize one remove was used withdraw keeping firm Note landmark lip nare tape holder Confirming breath condensate Auscultate confirm sounds stomach ensure entry Obtain radiograph evaluate neutral before Chest indicate above carina Reposition too low length Loosen adaptor Measure where exits anatomy Cut slight angle reinsert Reconfirm stethoscope VI Types Ventilators condition necessitating goals support considered when selecting type settings ventilators classified conventional frequency Approaches below detailed description presented Neonates requiring most often ventilated using pressure-limited Pressure-limited accomplished setting peak PIP that targets each any modes Synchronized intermittent mandatory SIMV Figure FIG Paw vol waveforms synchronized Drager Baby Mandatory set range Minimum Every starts preset between Total less than difference target result Inspiratory time operator all normally second Continuous available nonmechanical spontaneous L Spontaneous supported applied Delivered concentrations vary Assist control AC assist triggers pressure-targeted total PS No Buy Membership Category continue reading Learn more here You also needRespiratory Disorders NewbornProne PositioningInitiation Maintenance Weaning VentilationIntrapulmonary Shunting DeadspaceNoninvasive Positive VentilationNeurologic Control VentilationGeneral Principles Gas PhysicsModes Share Click share Twitter Opens new window Facebook Google Related Essentials