![]() ![]() The greatest challenge presented in the care of the critically ill infant on mechanical ventilation is to provide adequate gas exchange without causing oxygen toxicity due to what?ģ1. Respiratory distress syndrome (RDS), diffuse pneumonia, pulmonary edema, meconium aspiration, diaphragmatic hernia, prophylactic use, cyanotic congenital cardiac defect, persistent pulmonary hypertension of the neonate, and post op after major thoracic or abdominal surgery.ģ0. What are the pulmonary conditions for mechanical ventilation? What are the neurologic reasons for mechanical ventilation?Ĭomplete apnea, apneic periods leading to hypoxemia and bradycardia, ICH (intracranial hemorrhage), and drug depression.Ģ9. PaO2 less than 50 torr despite maximal CPAP therapy (around 10 cmH2O) and 60% or more oxygen.Ģ8. What is considered respiratory failure in neonates? Respiratory failure, neurologic, and pulmonary conditions.Ģ7. What are the indications for mechanical ventilation? Set VT-compressible volume (AKA effective tidal volume).Ģ6. What is the corrected tidal volume formula? TC factor x delta P = compressible volume (ml/cmH2O) PIP-PEEP= delta P.Ģ5. How do you calculate compressible volume? What factor allows us to consider the volume that is lost within the circuit?Ģ4. Because delivered volumes are so small when volume ventilating infants and small pediatric patients, what must be taken into account?Ģ3. As always, request a chest x-ray to verify proper tube placement after intubation.Ģ2. What is a rule to estimate the depth of intubation?Īdd six to the body weight in kilograms. What is the typical tidal volume goal for a neonatal patient?Ĥ-6 mL/kg in neonates and 6-8ml/kg in pediatrics.Ģ1. Volume cycled ventilation can be used on an infant that weigh more than what?Ģ0. If higher rates are needed, a mode of HFV must be used.ġ9. This mode of conventional ventilation can deliver rates up to 150/min. Time-triggered, pressure limited, time cycled mechanical ventilation. When evaluation of the neonates ABGs and vital signs indicates the need for mechanical ventilation, most neonatal patients require what? What should be decreased if the infant is breathing 50% oxygen or less and has unstable vital signs or pulmonary barotrauma?ġ8. Reduce the oxygen before decreasing CPAP to decrease the effects of oxygen toxicity.ġ7. What should be reduced if the infant is breathing > 50% oxygen while on CPAP? The flow is inadequate and should be increased.ġ6. ![]() ![]() What does it mean if the CPAP level decreases more than 2 cmH2O during inspiration? What is the indication of a sudden decrease in the CPAP level to zero?Ī disconnection at the patient or somewhere in the breathing circuit.ġ5. What is the maximum CPAP level in an infant?ġ4. What is the maximum CPAP level in a neonate?ġ3. How do we increase CPAP if PaO2 is too low and patients’ vital signs are acceptable?ġ2. Also, keep the PaCO2 less than 50-55 torr, and PH at least 7.25.ġ1. In general, the PaO2 should be kept between what? What is required for less mature and smaller infants who need suctioning and have an unstable pulmonary condition?Ĥ-5 cmH2O with FiO2 kept at the previously set level and flow rates of 5-10 L/min.ġ0. More mature and larger infants with fewer secretions and stable pulmonary conditions can have CPAP effectively applied how?Ībove the glottis by nasal prongs or a nasopharyngeal tube.Ĩ. This decision will be based upon factors such as the neonate’s gestational age and weight, amount of secretions that need to be suctioned, the pulmonary problem, and the likelihood of mechanical ventilation eventually being necessary.ħ. Decide on method of delivery (above or below the glottis). Obtain baseline ABG values & vital signs. What are the steps for the initiation of CPAP? Infant Respiratory Distress Syndrome (RDS).Ħ. ![]() What is the most common causes of a decreased FRC? PaO2 less than 50 on 80-100% oxygen, or an SaO2 less than 88% on 80-100% oxygen.ĥ. What is ventilatory failure in neonates?Ī PaCO2 less than 60 and a pH less than 7.24.ģ. Ventilator failure and oxygenation failure.Ģ. What are the indications for neonatal mechanical ventilation? ![]()
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