Neonatal ventilation: Scientific principles and evidence to help in practical management

Editor’s Note

Anupam Gupta

Abstract

Introduction: Newborn infants often require support for their respiratory management. Ventilatory management of term and preterm infants is the most important and arguably most challenging part of NICU care. While it is a lifesaving modality, use of ventilation comes with its own risk of lung damage associated with ventilator induced lung injury. With the development of technology and increased resources, we are in a position to save very premature infants to babies with severe meconium aspiration syndrome. With increase in number of neonatal units a need for improvement in understanding of neonatal ventilation is more acute than ever. Aim: To present and discuss a practical approach to neonatal ventilation based on current scientific and evidence base. Method: By the end of the workshop, participants would be able to: ï?· Learn about historical evolution of ventilation in newborns. ï?· Learn about scientific principles underlying the different ventilation strategies. ï?· Learn about different modes of ventilation and how to choose the most suitable one. ï?· Learn about practical approaches to initiating, titrating and terminating mechanical ventilation in newborns. ï?· Learn about Pulmonary graphics and how their understanding can help in optimizing ventilation. ï?· Learn about high-frequency ventilation in newborns and its use in difficult situations. ï?· Learn about ventilator-induced lung injury and current evidence on strategies to reduce the impact. ï?· Learn about non-invasive ventilations – BIPAP/CPAP/HF ï?· Learn about less invasive surfactant administration (LISA) and its role in current practice Clarify practical dilemmas and difficulties with help of question and answer session however, more significant in the case of rod-shaped ceria.

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