Page 579 - Clinical Application of Mechanical Ventilation

Neonatal Mechanical Ventilation 545

Key Terms

compression factor mean airway pressure (mPaw)
extracorporeal membrane nasal CPAP (N-CPAP)
oxygenation (ECMO) power
high frequency jet ventilation (HFJV) pressure-controlled ventilation

high frequency oscillatory ventilation surfactant
(HFOV or HFO) surfactant replacement
high frequency ventilation (HFV) volume-controlled ventilation

Learning Objectives

After studying this chapter and completing the review questions, the learner
should be able to:
List the indications for neonatal intubation and surfactant replacement
therapy.
List the types, generic names, trade names, and dosages of artificial
surfactants.

Describe the clinical application of CPAP.
Differentiate the factors affecting the use of pressure-controlled ventilation
and volume-controlled ventilation.
Discuss the indications and initial settings for neonatal mechanical ventilation.
Differentiate between HFPPV, HFJV, and HFOV.
Outline the initial HFOV settings and the changes of ventilator settings
based on patient condition.
Discuss the indications, patient selection, and clinical application of ECMO.

INTRODUCTION

Neonatal mechanical ventilation provides a unique challenge to many respiratory
care practitioners because neonates have different physiologic needs and laboratory
values from those of adults. Also, caring for neonates often requires very different
respiratory care equipment, supplies, and techniques. Because neonates are unable
to communicate, keen senses and the ability to observe and evaluate neonates in
distress is vital to providing appropriate care.
This chapter provides a working outline of respiratory care procedures in caring
for a neonate in distress. These procedures focus on neonatal care and range from
intubation and surfactant instillation immediately after birth to different types of neo-
natal mechanical ventilation.

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