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Conventional Ventilation vs. high frequency ventilation for neonates

April 3, 2016 | Author: | Posted in health and medicine

: Conventional Ventilation vs . high frequency ventilation for neonates

p write a report on the use of conventional ventilation vs . high frequency ventilation for neonates . Describe each type , the settings and the rationale of each A conventional ventilator is a device that assists in respiration . It can supply oxygen to the lungs at various pressure at which the lungs can open . It usually operates with a respiration rate ranging from 0 to 120 breaths per minute , slower than High-frequency ventilators . A ventilator is utilized often to enable normal respiration in prematurely [banner_entry_middle]

br born infants or those with severe respiratory conditions . In several such conditions , it is important that oxygen is supplied to the lungs and carbon dioxide removed . The ventilator setting can be adjusted according to the blood gas and the findings of the chest X-rays Infants utilizing conventional ventilators can suffer lung damage if the lungs are severely diseased or if serious injury is present Ventilators can damage the air sacs when oxygen is supplied at a high pressure . Often pneumothorax or pulmonary interstitial emphysema can develop resulting in air leakage from the lungs

The various setting in the conventional ventilator includes IMV or mode breathe rates , FiO2 , inspiratory time , PIP , and PEEP

Once the neonatal is placed on the ventilator , the blood gas level should be determined every 15 to 20 minutes . Besides the PaO2 , PaCO2 and the pH should be determined . Once the patient is resuscitated and stabilized , the respiratory rate should be brought down to 30 to 40 breathes per minute . The peak inspiratory pressure (PIP ) should be maintained at 16 to 30 depending on the child ‘s weight . The FiO2 should be kept at 0 .4 to 1 .0 , and the inspiratory time should be controlled at 0 .3 to 0 .5 of a second . The FiO2 can be raised in case the partial pressure of oxygen is still low . If the partial pressure of carbon dioxide is high , the PIP should be raised

High-frequency ventilator (HFV ) is a specialized type of a mechanical ventilator that utilizes high respirator rates (above 150 respirations per minute with a higher frequency oscillatory ventilation rate ranging from 5 to 15 Hz ) and tidal volume (below that of dead space . The HFV permits active inspiration and active expiration . Neonatal who cannot benefit from convention ventilator even after using the sophisticated versions or after intensifying them (in to increase air pressure levels and respiratory rates ) may benefit form HFV . It can also be utilized to reduce conditions in which air leaks from the lungs such as pneumothorax and pulmonary interstitial emphysema . It is utilized in rescue treatment in neonatal as the gaseous exchange is much more superior . HFV is applied by a few hospitals to provide relief from respiratory distress syndrome (RDS . However , the exact benefits of HFV in RDS need to be studied further . HFV is also utilized to provide relief in congenital hernia cases and during surgery (in the tracheal and larynx areas . It is also beneficial in infants suffering from pulmonary hypertension as it can improve gas exchange and ventilation The other conditions in which HFV can be utilized include reduced compliance , meconium entry into the lungs , pneumonia , atelectases , and under-development of the lungs

The various settings in the HFV include amplitude (similar to tidal volume of the conventional ventilators , frequency (similar to rate and should be changed according to the weight of the infant , mean airway pressure (similar to peak airway volume ) and FiO2

HFV is usually applied if conventional ventilation fails in maintaining appropriate partial oxygen pressure levels or the lungs are going to suffer damage due to barotrauma . However , if pulmonary obstruction is present , it could result in over-inflation . Frequently in neonatals , it may be necessary to increase the PIP beyond 25 mbar to save lives . It may be very easy to shift the patient from conventional ventilation to HFV . Some advanced ventilator provides a button which when pressed automatically activates the HFV mechanism . Certain adjustments may have to be made when required in some conditions . In cases of reduced oxygenation , the FiO2 and the mean airway pressure (MAP ) should be increased . In case of under-ventilation , the amplitude should be increased and the frequency should be decreased . X-rays taken before and after administering the procedure can be utilized to determine the expansion in lung volumes . During weaning , the FiO2 and MAP should be reduced . The individual can be shifted over to a conventional ventilator . HFV may be continued in case of hypoxia , hyperoxia hypercapnia , hypocapnia , over-inflation , hypotension or increase in CVP .Retrieved

Battin , M (2001 . High Frequency Ventilator . Retrieved 30 January 2007 . from Newborn Services Clinical Guideline Web site : HYPERLINK “http /www .adhb .govt .nz /newborn /Guidelines /Respiratory /HFOV /HFOV .htm http /www .adhb .govt .nz /newborn /Guidelines /Respiratory /HFOV /HFOV .htm

Klien , J .M (2006 . Protocol for Initial Respiratory Settings for Mechanical Ventilation of Infants . Retrieved 30 January , 2007 . from University of IOWA Web site : HYPERLINK “http /www .uihealthcare .com /depts /med /pediatrics /iowaneonatologyhandboo k /pulmonary /ventilationsettings .html http /www .uihealthcare .com /depts /med /pediatrics /iowaneonatologyhandbook /pulmonary /ventilationsettings .html

NICU (2002 . Mechanical Ventilators . Retrieved 30 January , 2007 . from University of Washington Web site : HYPERLINK “http /neonatal .peds .washington .edu /NICU-WEB /vents .stm Authors http /neonatal .peds .washington .edu /NICU-WEB /vents .stm Authors

Rauch , D (2006 . Mechanical ventilator – infants . Retrieved 30 January 2007 . from Medline Plus Web site : HYPERLINK “http /www .nlm .nih .gov /medlineplus /ency /article /007240 .htm http /www .nlm .nih .gov /medlineplus /ency /article /007240 .htm

Sabella , J (2000 . High Frequency Ventilation for Pediatric and Neonatal Patients . Retrieved 30 January , 2007 . from Continuing Education for Nurses Web site : HYPERLINK “http /www .continuingeducation .com /nursing /ventilation /ventilation .pdf www .continuingeducation .com /nursing /ventilation /ventilation .pdf

Stachow , R (1995 . High Frequency Ventilation Basics and Practical Application . Retrieved 30 January , 2007 . from University of IOWA Web site : HYPERLINK “http /www .draeger-medical .com /MT /internet /pdf /CareAreas /PerinatalCare pc_baby8000_vent_en .pdf www .draeger-medical .com /MT /internet /pdf /CareAreas /PerinatalCare /pc_baby8 000_vent_en .pdf

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