Mechanical Ventilation of the Neonate: Principles and Strategies

Steven      M. Donn

Abstract

The advent of microprocessor-based technology has revolutionalized the treatment of respiratory failure in the newborn. Clinicians are now able to customize ventilatory strategies to the specific pathophysiology of the patient. Sophisticated monitoring provides breath-to-breath feedback on patient-ventilator interactions. This paper will focus upon the basic principles of mechanical ventilation, and will review various strategies that may be employed to manage the wide range of respiratory disorders encountered by preterm and term newborn infants, including respiratory distress syndrome, meconium aspiration syndrome, persistent pulmonary hypertension of the newborn, and bronchopulmonary dysplasia.

Keywords: Newborn, prematurity, respiratory failure, mechanical ventilation, respiratory distress syndrome, PPHN, intermittent mandatory ventilation, high-frequency ventilation, hypoxemia, hypercapnia