eMedicine Specialties > Pediatrics: Cardiac Disease and Critical Care Medicine > Neonatology

Assisted Ventilation of the Newborn: Multimedia

Author: Massimo Bellettato, MD, Director, Neonatal and Paediatric Units, Thiene's Hospital, Italy
Coauthor(s): Wally Carlo, MD, Director, Professor, Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham
Contributor Information and Disclosures

Updated: Mar 19, 2008

Multimedia

Relationships among ventilator-controlled variabl...
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Media file 1: Relationships among ventilator-controlled variables (shaded circles) and pulmonary mechanics (unshaded circles) that determine minute ventilation during pressure-limited time-cycled ventilation. The relationships between the circles joined by solid lines are described by simple mathematical equations. The dashed lines represent relationships that cannot be calculated precisely without considering other variable such as pulmonary mechanics. Thus, simple mathematical equations determine the time constant of the lungs, the pressure gradient, and the inspiratory time. In turn, these determine the delivered tidal volume, which, when multiplied by the respiratory frequency, provides the minute ventilation. Alveolar ventilation can be calculated from the product of tidal volume and frequency when dead space is subtracted from the former (Adapted from Chatburn RL, Lough MD).
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Relationships among ventilator-controlled variabl...

Relationships among ventilator-controlled variables (shaded circles) and pulmonary mechanics (unshaded circles) that determine minute ventilation during pressure-limited time-cycled ventilation. The relationships between the circles joined by solid lines are described by simple mathematical equations. The dashed lines represent relationships that cannot be calculated precisely without considering other variable such as pulmonary mechanics. Thus, simple mathematical equations determine the time constant of the lungs, the pressure gradient, and the inspiratory time. In turn, these determine the delivered tidal volume, which, when multiplied by the respiratory frequency, provides the minute ventilation. Alveolar ventilation can be calculated from the product of tidal volume and frequency when dead space is subtracted from the former (Adapted from Chatburn RL, Lough MD).

Determinants of oxygenation during pressure-limit...
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Media file 2: Determinants of oxygenation during pressure-limited time-cycled ventilation. Shaded circles represent ventilator-controlled variables. Solid lines represent the simple mathematical relationships that determine mean airway pressure and oxygenation, whereas dashed lines represent relationships that cannot be quantified in a simple mathematical way (From Carlo WA, Greenough A, Chatburn RL).
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Determinants of oxygenation during pressure-limit...

Determinants of oxygenation during pressure-limited time-cycled ventilation. Shaded circles represent ventilator-controlled variables. Solid lines represent the simple mathematical relationships that determine mean airway pressure and oxygenation, whereas dashed lines represent relationships that cannot be quantified in a simple mathematical way (From Carlo WA, Greenough A, Chatburn RL).

Effects of incomplete inspiration (A) or incomple...
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Media file 3: Effects of incomplete inspiration (A) or incomplete expiration (B) on gas exchange. An incomplete inspiration leads to decreases in tidal volume and mean airway pressure. Hypercapnia and hypoxemia may result. An incomplete expiration may lead to decreases in compliance and tidal volume and an increase in mean airway pressure. Hypercapnia with a decrease in PaO2 may result. However, gas trapping and its resulting increase in mean airway pressure may decrease venous return, decreasing cardiac output and impairing oxygen delivery (From Carlo WA, Greenough A, Chatburn RL).
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Effects of incomplete inspiration (A) or incomple...

Effects of incomplete inspiration (A) or incomplete expiration (B) on gas exchange. An incomplete inspiration leads to decreases in tidal volume and mean airway pressure. Hypercapnia and hypoxemia may result. An incomplete expiration may lead to decreases in compliance and tidal volume and an increase in mean airway pressure. Hypercapnia with a decrease in PaO2 may result. However, gas trapping and its resulting increase in mean airway pressure may decrease venous return, decreasing cardiac output and impairing oxygen delivery (From Carlo WA, Greenough A, Chatburn RL).

Estimation of optimal inspiratory and expiratory ...
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Media file 4: Estimation of optimal inspiratory and expiratory times based on chest wall motion (From Ambalavanan N, Carlo WA).
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Estimation of optimal inspiratory and expiratory ...

Estimation of optimal inspiratory and expiratory times based on chest wall motion (From Ambalavanan N, Carlo WA).

More on Assisted Ventilation of the Newborn

References
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Further Reading

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Keywords

assisted ventilation of the newborn, assisted ventilation of the neonate, respiratory support, breathing support, neonatal care, chronic lung disease, pulmonary mechanics, gas exchange, lung injury, control of breathing, conventional mechanical ventilation, CMV, hypercapnia, ventilation/perfusion, V/Q, hypoventilation, venoarterial shunts, apnea of prematurity, respiratory distress syndrome, RDS, high-frequency ventilation, HFV, hypoxemia, congenital cyanotic heart disease, patent ductus arteriosus, interstitial lung disease, gas trapping, metabolic acidosis, metabolic alkalosis

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Contributor Information and Disclosures

Author

Massimo Bellettato, MD, Director, Neonatal and Paediatric Units, Thiene's Hospital, Italy
Disclosure: Nothing to disclose.

Coauthor(s)

Wally Carlo, MD, Director, Professor, Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham
Wally Carlo, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Thoracic Society, Society for Pediatric Research, and Society of Critical Care Medicine
Disclosure: Nothing to disclose.

Medical Editor

Steven M Donn, MD, Professor of Pediatrics, Director, Neonatal-Perinatal Medicine, Department of Pediatrics, University of Michigan Health System
Steven M Donn, MD is a member of the following medical societies: American Pediatric Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine.com, Inc
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Brian S Carter, MD, FAAP, Professor of Pediatrics, Department of Pediatrics, Division of Neonatology, Vanderbilt University School of Medicine; Co-director, Pediatric Advance Comfort Team, Vanderbilt Children's Hospital
Brian S Carter, MD, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, National Hospice and Palliative Care Organization, and National Perinatal Association
Disclosure: Nothing to disclose.

CME Editor

Carol L Wagner, MD, Professor of Pediatrics, Medical University of South Carolina
Carol L Wagner, MD is a member of the following medical societies: American Academy of Pediatrics, American Chemical Society, American Medical Women's Association, American Public Health Association, American Society for Bone and Mineral Research, American Society for Clinical Nutrition, Massachusetts Medical Society, National Perinatal Association, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Chief Editor

Ted Rosenkrantz, MD, Professor, Departments of Pediatrics and Obstetrics/Gynecology, Division of Neonatal-Perinatal Medicine, University of Connecticut School of Medicine
Ted Rosenkrantz, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Pediatric Society, Connecticut State Medical Society, Eastern Society for Pediatric Research, and Society for Pediatric Research
Disclosure: Nothing to disclose.

 
 
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