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Respiratory Care for the Ventilated Neonate
Invasive ventilation is often necessary for the treatment of newborn infants with respiratory insufficiency. The neonatal patient has unique physiological characteristics such as small airway caliber, few collateral airways, compliant chest wall, poor airway stability, and low functional residual ca...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110042/ https://www.ncbi.nlm.nih.gov/pubmed/30186538 http://dx.doi.org/10.1155/2018/7472964 |
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author | Rocha, Gustavo Soares, Paulo Gonçalves, Américo Silva, Ana Isabel Almeida, Diana Figueiredo, Sara Pissarra, Susana Costa, Sandra Soares, Henrique Flôr-de-Lima, Filipa Guimarães, Hercília |
author_facet | Rocha, Gustavo Soares, Paulo Gonçalves, Américo Silva, Ana Isabel Almeida, Diana Figueiredo, Sara Pissarra, Susana Costa, Sandra Soares, Henrique Flôr-de-Lima, Filipa Guimarães, Hercília |
author_sort | Rocha, Gustavo |
collection | PubMed |
description | Invasive ventilation is often necessary for the treatment of newborn infants with respiratory insufficiency. The neonatal patient has unique physiological characteristics such as small airway caliber, few collateral airways, compliant chest wall, poor airway stability, and low functional residual capacity. Pathologies affecting the newborn's lung are also different from many others observed later in life. Several different ventilation modes and strategies are available to optimize mechanical ventilation and to prevent ventilator-induced lung injury. Important aspects to be considered in ventilating neonates include the use of correct sized endotracheal tube to minimize airway resistance and work of breathing, positioning of the patient, the nursing care, respiratory kinesiotherapy, sedation and analgesia, and infection prevention, namely, the ventilator-associated pneumonia and nosocomial infection, as well as prevention and treatment of complications such as air leaks and pulmonary hemorrhage. Aspects of ventilation in patients under ECMO (extracorporeal membrane oxygenation) and in palliative care are of increasing interest nowadays. Online pulmonary mechanics and function testing as well as capnography are becoming more commonly used. Echocardiography is now a routine in most neonatal units. Near infrared spectroscopy (NIRS) is an attractive tool potentially helping in preventing intraventricular hemorrhage and periventricular leukomalacia. Lung ultrasound is an emerging tool of diagnosis and can be of added value in helping monitoring the ventilated neonate. The aim of this scientific literature review is to address relevant aspects concerning the respiratory care and monitoring of the invasively ventilated newborn in order to help physicians to optimize the efficacy of care. |
format | Online Article Text |
id | pubmed-6110042 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-61100422018-09-05 Respiratory Care for the Ventilated Neonate Rocha, Gustavo Soares, Paulo Gonçalves, Américo Silva, Ana Isabel Almeida, Diana Figueiredo, Sara Pissarra, Susana Costa, Sandra Soares, Henrique Flôr-de-Lima, Filipa Guimarães, Hercília Can Respir J Review Article Invasive ventilation is often necessary for the treatment of newborn infants with respiratory insufficiency. The neonatal patient has unique physiological characteristics such as small airway caliber, few collateral airways, compliant chest wall, poor airway stability, and low functional residual capacity. Pathologies affecting the newborn's lung are also different from many others observed later in life. Several different ventilation modes and strategies are available to optimize mechanical ventilation and to prevent ventilator-induced lung injury. Important aspects to be considered in ventilating neonates include the use of correct sized endotracheal tube to minimize airway resistance and work of breathing, positioning of the patient, the nursing care, respiratory kinesiotherapy, sedation and analgesia, and infection prevention, namely, the ventilator-associated pneumonia and nosocomial infection, as well as prevention and treatment of complications such as air leaks and pulmonary hemorrhage. Aspects of ventilation in patients under ECMO (extracorporeal membrane oxygenation) and in palliative care are of increasing interest nowadays. Online pulmonary mechanics and function testing as well as capnography are becoming more commonly used. Echocardiography is now a routine in most neonatal units. Near infrared spectroscopy (NIRS) is an attractive tool potentially helping in preventing intraventricular hemorrhage and periventricular leukomalacia. Lung ultrasound is an emerging tool of diagnosis and can be of added value in helping monitoring the ventilated neonate. The aim of this scientific literature review is to address relevant aspects concerning the respiratory care and monitoring of the invasively ventilated newborn in order to help physicians to optimize the efficacy of care. Hindawi 2018-08-13 /pmc/articles/PMC6110042/ /pubmed/30186538 http://dx.doi.org/10.1155/2018/7472964 Text en Copyright © 2018 Gustavo Rocha et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Article Rocha, Gustavo Soares, Paulo Gonçalves, Américo Silva, Ana Isabel Almeida, Diana Figueiredo, Sara Pissarra, Susana Costa, Sandra Soares, Henrique Flôr-de-Lima, Filipa Guimarães, Hercília Respiratory Care for the Ventilated Neonate |
title | Respiratory Care for the Ventilated Neonate |
title_full | Respiratory Care for the Ventilated Neonate |
title_fullStr | Respiratory Care for the Ventilated Neonate |
title_full_unstemmed | Respiratory Care for the Ventilated Neonate |
title_short | Respiratory Care for the Ventilated Neonate |
title_sort | respiratory care for the ventilated neonate |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110042/ https://www.ncbi.nlm.nih.gov/pubmed/30186538 http://dx.doi.org/10.1155/2018/7472964 |
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