Non-Invasive Mechanical Ventilation in Neonatology

Arnaldo      Prata Barbosa; Vera      Lucia Jornada Krebs; Miriam      Perez de Figueiredo

Abstract

Non-invasive ventilation (NIV) is a form of mechanical ventilation that does not use an endotracheal tube, thus avoiding the complications associated with this invasive form of ventilatoy support. This article will emphasize the use of NIV with two pressure levels in the management of the neonate with respiratory failure. The physiological principles of its application and the main indications of NIV are discussed, such as: (i) prevention and treatment of apnea of prematurity; (ii) early weaning and ventilatory support following tracheal extubation; (iii) treatment of hypoxemic respiratory failure; and (iv) neonatal resuscitation in the delivery room. The modes of administration, the type of devices, the initial ventilatory settings and the necessary interfaces for its use are emphasized. Finally, the authors address the care needed to manage the newborn undergoing NIV and the complications of this type of ventilatory support, as well as the possibility of using new devices, exclusively designed for NIV.

Keywords: Positive-pressure respiration, non-invasive positive-pressure ventilation, continuous positive airway pressure, intermitent positive-pressure ventilation, ventilator weaning, respiratory insufficiency, neonatology, prematurity, Apnea, hypoxemic respiratory failure