Clinical Algorithm for Pressure-Limited Ventilation of Neonates with Respiratory Distress Syndrome

Abstract

To optimize the mechanical ventilation of neonates, one must have a thorough understanding of ventilator dynamics and the ability to interpret blood gases. To the inexperienced respiratory therapist or physician, the many treatment options available as the clinical condition changes often lead to confusion and haphazard alterations of ventilator settings. To simplify the treatment of neonates with respiratory distress syndrome who are receiving pressure-limited ventilation, we have designed an algorithm based on blood gas results. Although we have made several assumptions about respiratory mechanics during assisted ventilation, this schema is supported by the results of previous clinical studies in neonates with respiratory problems as well as by lung model studies. These guidelines, in conjunction with the clinical evaluation of the patient, should facilitate sound decision making and consistency of care during assisted ventilation in newborn infants.