Neonatal ventilators: how do they differ?

Abstract

Remarkable technological advances over the past two decades have brought dramatic changes to the neonatal intensive care unit. Microprocessor-based mechanical ventilation has replaced time-cycled, pressure-limited, intermittent mandatory ventilation with almost limitless options for the management of respiratory failure in the prematurely born infant. Unfortunately, much of the infusion of technology occurred before the establishment of a convincing evidence base. This review focuses on the basic principles of mechanical ventilation, nomenclature and the characteristics of both conventional and high-frequency devices.

Feasibility of Mid-Frequency Ventilation Among Infants With Respiratory Distress Syndrome

“…21 Modern ventilators can achieve faster pressurization of the system as long as optimum inspiratory rise time is provided. 31 The current study did not show impairment of gas exchange or hemodynamics even at faster frequencies and very low tidal volumes, consistent with clinical, 32 animal, 24 and experimental laboratory 33 studies. We speculate that, although tidal volume was only slightly larger than the anatomical dead space, fast frequencies maintained adequate alveolar minute ventilation.…”

Congenital lung lesions: Postnatal management and outcome

“…Broadly, 2 modes of assisted ventilation strategy are employed to support a neonate in respiratory distress. 19 The conventional ventilation traditionally delivers tidal ventilation based on the pressure settings set by the clinicians and stops when pressure is reached. While the volume guarantees ventilation, which sets the volume, the ventilator generates the necessary parameters to deliver the set volume.…”

Closed-Loop Control of Mechanical Ventilation: Description and Classification of Targeting Schemes

“…MV total ϭ MV mandatory ϩ MV spontaneous (14) where MV is minute ventilation. If the total minute ventilation is below the target value, the mandatory breath frequency will increase.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Without exception, those authors took the approach of "name and describe," using the mode names coined by manufacturers and the descriptions from the operator's manuals. That approach is appropriate for the reader with a casual, general interest in modes or the need to know the details of a single mode.…”