Use of Mechanical Ventilation in the Neonate
Jonathan M. Klein, MD
Peer Review Status: Internally Peer Reviewed
Suggested Initial Respirator Settings
|Condition||Rate1 (Breaths/Min)||PIP2 (CM H2O)||PEEP (CM H2O)||FiO2|
|Congestive Heart Failure (Pulmonary Edema)||15-25||18-22||4-6||*|
|Meconium Aspiration Syndrome||30-60||24-30||4-6||**|
(1) Inspiratory Time--All neonates should have aninspiratory time of 0.3 to 0.5 seconds and an expiratory time not less than 0.5 seconds unless the rate exceeds 60/minute. At rates above 60, use equal inspiratory and expiratory times (I:E=1:1).
(2) Confirmation of correct PIP should always be determined by appropriate chest wall excursion.
* Adjust FiO2 as indicated to maintain oxygen saturation 85%-95% (PaO2 50-70mm Hg).
** Because of the risk of right to left shunting (PFC), the FiO2 in this condition is adjusted to maintain the oxygen saturation greater than 95% (PaO2 > 80mm Hg) in term infants.