Respiratory support and ventilations policy 2.0.pdf

Respiratory support and ventilations policy in newborn

1. Ventilator policy Compliance Resistance Time
Constant
FRC Mode Tidal
volume
ml/kg
PIP
cmH2O
PEEP
cmH2O
Rate
/min
Ti
sec
FiO2
Respiratory Distress
Syndrome RDS
Mainly
affected
↓decreased
Normal decreased ↓ decreased
↓↓
AC 4-6ml/kg 18-20 5-8 30-60 0.35-0.35 0.3.0.4
Transient
Tachypnea of the
Newborn TTN
Mainly
affected
↓decreased
Normal or
Increased↑
Normal ↓decreased AC 4-6ml/kg 10-16 5-6 40 0.35-0.4 0.3.0.4
Meconium
Aspiration
Syndrome MAS
Mainly
affected
↓decreased
Normal or
Increased↑
Normal, ↑,↓ Adequate,
↑↓
AC 4-6ml/kg 10-16 2-5 low ≤30 0.35-0.5
long
expiratory
time
0.3.0.4
Acute

Bronchopulmonary
Dysplasia BPD
Mainly
affected
↓decreased
Normal or
Increased↑
↑,↓ ↑,↓ AC 5-8 moderate 4-6 40-60 0.35-0.45
higher
0.3-0.4
PCO2: 46-60
mmHg
SPO2:
88-98%
Chronic

Bronchopulmonary
Dysplasia BPD
Mainly
affected
↓decreased
Normal or
Increased↑
↑,↓ ↑,↓ AC 6-10 as
increased
dead space
High 8-12cm
* 14 in tracheo
bronco malecia
20-30 0.5-0.7s to
overcome
airway
resistance
0.3-0.4
Persistent
Pulmonary
Hypertension PPHN

Gentle ventilation
↓ decreased ↑ increased ↓ decreased ↓ decreased SIMV/AC,
HFOV
4-6 20-25 4-6 40-60 0.3-0.5 0.6-1.0
Pneumonia
Congenital and
Neonatal
↓ decreased Normal ↓ decreased ↓↓
decreased
AC 4-6 18-20 5-8 30-60 0.35-0.4 0.3-0.4
Apnea of
Prematurity
Normal
compliance
Normal
resistance
Normal
time
constant
Normal
FRC
AC Low 3-4 Normal CPAP,
caffeine
citrate,
monitoring
respiratory
effort
low
Pulmonary
Hemorrhage
↓ decreased ↑ increased ↓ decreased ↓↓
decreased
AC 4-6 20-25 6-8 30-60 0.35-0.4 0.3-0.4
Pneumothorax ↓↓ severely
decreased
↑↑ severely
increased
↓↓ severely
decreased
↓↓
decreased
SIMV/AC 4-6 15-20 4-6 20-40 0.3-0.35 0.3-0.4
Congenital
Diaphragmatic
Hernia CDH
Decreased
compliance
due to lung
hypoplasia
and
compression
Normal to
increased
resistance due
to airway
malformations
Increased
time
constant
Decreased
FRC due to
lung
hypoplasia
AC 4-5ml/kg ≤25Low 2-5 Low

Paw:
<12 cmH2O
40-60 0.25-.4 0.3-0.4