ABSTRACT
This article presents an overview of the varied modes of ventilation and supportive adjuncts for the pediatric patient. Ventilatory management has changed over the past few decades with the advent of high-frequency ventilation, pressure control-inverse ratio, pressure-regulated volume control, volume support, noninvasive bi-level pressure ventilation such as BiPAP, and the emergence of adjuncts to improve oxygenation such as surfactant, extracorporeal membrane oxygenation, nitric oxide, and total and partial liquid ventilation. Ventilatory management of pediatric patients mandates an armamentarium including guided imagery and the use of speech enhancers. A multidisciplinary team approach is essential.
Subject(s)
Respiration, Artificial/methods , Respiration, Artificial/trends , Child , Critical Care , Humans , Intensive Care Units, Pediatric , Pediatric Nursing , Respiration, Artificial/nursingABSTRACT
Advances in technology have produced more sophisticated, diverse modes of mechanical ventilation. Efforts to reduce neonatal morbidity and mortality have led clinicians to use a myriad of ventilatory support modalities. It is imperative that critical care nurses become aware of the indications, advantages, and disadvantages of the new modes of ventilatory support. This article reviews respiratory physiology and presents new trends in neonatal mechanical ventilation.
Subject(s)
Neonatal Nursing/methods , Respiration, Artificial/methods , Critical Care , Humans , Infant, Newborn , Respiration, Artificial/nursing , Respiration, Artificial/trends , Respiratory Function TestsABSTRACT
It is the philosophy of our institution to provide primary surgical repair of complex congenital heart defects to avoid pulmonary and myocardial damage that occurs over time. Application of knowledge of the normal physiology and a clear understanding of the physiologic alterations of complex lesions are essential in understanding the effect of positive-pressure ventilation in complex CHD. The care and management of patients with CHD have a great deal to do with ventilatory management, which can be life-threatening when not fully understood but lifesaving when mastered. A dedicated team approach enhances communication and collaborative practice, which provides optimal patient management and outcome.
