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Neonatal Ventilation

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Dang Thanh Tuan
Dang Thanh Tuan
Saúde e medicina
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Invasive Neonatal Ventilation Dr Badr Chaban 28/01/09
 
Invasive Neonatal Ventilation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ventilatory Techniques ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ventilatory Styles ,[object Object],[object Object],[object Object]
Goals of Mechanical Ventilation ,[object Object],[object Object],[object Object],[object Object]
Ideal Mode of Ventilation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Ideal Ventilator Design ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Carbon Dioxide (CO2) Elimination ,[object Object],[object Object]
Copyright ©1999 American Academy of Pediatrics Carlo, W. A. et al. Pediatrics in Review 1999;20:117-126e Relationships among various ventilator-controlled (shaded circles) and
 
Copyright ©1999 American Academy of Pediatrics Carlo, W. A. et al. Pediatrics in Review 1999;20:117-126e Determinants of oxygenation during pressure-limited,
[object Object],[object Object]
 
COMPLIANCE ,[object Object],[object Object]
[object Object]
[object Object],[object Object]
Airway resistance depends on ,[object Object],[object Object],[object Object],[object Object]
Resistance Δ Pressure (cm H2O) Δ Flow (L/sec) Normal lungs: 20-40 cm H2O/L/sec RDS: 20-40 cm H2O/L/sec Intubated infant: 50-150 cm H2O/L/sec
The time constant of the respiratory system is a measure of the time necessary for the alveolar pressure to reach 63% of the change in airway pressure ,[object Object],[object Object]
Carlo, W. A. et al. Pediatrics in Review 1999;20:117-126e
CMV
IMV
SIMV
SIMV+VG
IPPV
SIPPV A/C
SIPPV+VG
PSV ,[object Object]
[object Object],[object Object],[object Object],[object Object]
PROPORTIONAL ASSIST VENTILATION PAV ,[object Object]
Ideal Monitoring Features ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
 
 
 
Neonatal Ventilation Dr Badr Chaban 11/02/09
High-Frequency Ventilation ,[object Object],[object Object],[object Object]
[object Object],[object Object]
Indications for high frequency ventilation include ,[object Object],[object Object],[object Object]
Terminology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Making adjustments once established on HFV Increase Frequency  (1-2Hz) if Amplitude Minimal Decrease Frequency  (1-2Hz) if Amplitude Maximal Decrease MAP (1-2cmH 2 O) Increase MAP (1-2cmH 2 O) Decrease Amplitude Increase Amplitude Decrease FiO 2 Increase FiO 2 Over Ventilation Under Ventilation Over Oxygenation Poor Oxygenation
Continuous Positive Airway Pressure ,[object Object],[object Object],[object Object],[object Object],[object Object]
Advantages of CPAP ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
COIN trial ,[object Object]
[object Object]
REVE trial ,[object Object],[object Object],[object Object]
Complication ,[object Object],Nasal obstruction ,[object Object],[object Object],Abdominal Distension from Swallowing Air ,[object Object],[object Object],[object Object],[object Object],Pneumothorax ,[object Object],Nasal Septal Erosion or Necrosis
NIPPV ,[object Object]
[object Object]
HOW DOES NIPPV WORK ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
SNIPPV ,[object Object]
WHAT VENTILATOR SETTINGS SHOULD WE USE DURING NIPPV? ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
NON-INVASIVE SYNCHRONISED MECHANICAL VENTILATION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
[object Object],[object Object],[object Object],[object Object]
In summary, ,[object Object],[object Object],[object Object]
S.NCPAP setting ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]

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Neonatal Ventilation

  • 1. Invasive Neonatal Ventilation Dr Badr Chaban 28/01/09
  • 2.  
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  • 8.
  • 9.
  • 10. Copyright ©1999 American Academy of Pediatrics Carlo, W. A. et al. Pediatrics in Review 1999;20:117-126e Relationships among various ventilator-controlled (shaded circles) and
  • 11.  
  • 12. Copyright ©1999 American Academy of Pediatrics Carlo, W. A. et al. Pediatrics in Review 1999;20:117-126e Determinants of oxygenation during pressure-limited,
  • 13.
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  • 17.
  • 18.
  • 19. Resistance Δ Pressure (cm H2O) Δ Flow (L/sec) Normal lungs: 20-40 cm H2O/L/sec RDS: 20-40 cm H2O/L/sec Intubated infant: 50-150 cm H2O/L/sec
  • 20.
  • 21. Carlo, W. A. et al. Pediatrics in Review 1999;20:117-126e
  • 22. CMV
  • 23. IMV
  • 24. SIMV
  • 26. IPPV
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  • 40. Neonatal Ventilation Dr Badr Chaban 11/02/09
  • 41.
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  • 44.
  • 45.
  • 46. Making adjustments once established on HFV Increase Frequency  (1-2Hz) if Amplitude Minimal Decrease Frequency  (1-2Hz) if Amplitude Maximal Decrease MAP (1-2cmH 2 O) Increase MAP (1-2cmH 2 O) Decrease Amplitude Increase Amplitude Decrease FiO 2 Increase FiO 2 Over Ventilation Under Ventilation Over Oxygenation Poor Oxygenation
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