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Iowa Neonatology Handbook: Pulmonary
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
|
|
RDS
|
30-40
|
16-24
|
4-6
|
*
|
|
Primary Apnea
|
15-25
|
14-20
|
3-4
|
*
|
|
Congestive Heart Failure
(Pulmonary Edema)
|
15-25
|
18-22
|
4-6
|
*
|
|
Meconium Aspiration Syndrome
|
30-60
|
24-30
|
4-6
|
**
|
|
Pneumonia
|
30-40
|
24-30
|
6-8
|
**
|
(1) Inspiratory Time--All neonates should have an
inspiratory 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.
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