Contents Chapter Topic Page Neonatology Respiratory Cardiology

) Changing of Ventilator settings:
1. To produce an increase in pO2 either: -
a) Increase FiO2 concentration.
b) Increase PEEP.
c) Increase PIP (increases minute volume).
d) RARELY Increase I/E ratio (prolong inspiration)
2. To produce a decrease in pCO2 either: -
a) Increase Rate (increases minute volume)
b) Decrease I/E ratio (prolong expiration)
c) Increase PEEP in worsening lung disease. Decrease PEEP in
recovery phase.
3. Do the opposite to decrease paO2 or to increase paCO2.
Minute volume = tidal volume (volume per breath) x rate per minute
With volume-limited ventilators minute volume can be calculated (use tidal volume = 4-6
ml/kg)
With pressure-limited respirators - increasing peak inspiratory pressure results in increased
minute volume.
e) Sedation and Ventilation
Avoid paralysing the child (e.g. with pancuronium) as far as possible. Paralysing
has been shown to result in poorer lung function and other complications.
Use morphine infusion or intermittent bolus as an analgesia and sedative.
d) Complications of ventilation
Consider the following if the child deteriorates on ventilation:
ETT Dislodged;
Obstructed.
Pneumothorax
Esophagus position
Ventilator tubes disconnected.
Ventilator malfunction
Intraventricular Haemorrhage
Worsening of the primary condition.