Keterangan
Non-invasive ventilation (NIV) is a critical therapeutic approach in neonatal care for infants with respiratory distress. Respiratory Support: NIV provides respiratory support to infants with conditions such as respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), or congenital anomalies. NIV is favored to avoid endotracheal intubation and the associated complications, as it can be gentler on an infant's fragile airways. The pressure and oxygen levels are carefully adjusted to optimize oxygenation and reduce the work of breathing.
Continuous monitoring is essential to ensure the infant's comfort and response to NIV, with adjustments made as needed. Complications such as nasal injury or abdominal distension can occur, necessitating careful attention and management. The duration of NIV varies depending on the infant's condition and progress. Some may need it for a short time, while others may require more prolonged support. As the infant's condition improves, a gradual weaning process is initiated, transitioning from NIV to conventional oxygen therapy.
Ringkasan
- The presentation discusses non-invasive respiratory support for newborns, emphasizing the importance of avoiding intubation and its associated complications like bio trauma, volume trauma, and BPD. Indications for intubation include prematurity under 25 weeks, severe RDS causing apnea, cardiovascular collapse, and congenital malformations hindering non-invasive ventilation. Non-invasive methods are favored to minimize lung injury and chronic lung disease.
- Non-invasive ventilation includes HFNC, CPAP, and NIPPV. HFNC delivers heated, humidified high-flow nasal cannula, reducing dead space and resistance, primarily for step-down weaning and post-extubation support. CPAP, or continuous positive airway pressure, maintains functional residual capacity (FRC), splints airways, and reduces airway resistance, decreasing the need for mechanical ventilation and surfactant.
- Potential complications of non-invasive ventilation include failure of support, nasal injury, CPAP belly due to gastric inflation, and air leak syndromes. Contraindications include congenital diaphragmatic hernia (CDH), nasal injuries or obstructions, and immediate post-operative GI surgery. Weaning from non-invasive ventilation involves gradually reducing FiO2 and pressure, stepping down to lower support modes like HFNC from CPAP.
- NIPPV (non-invasive positive pressure ventilation), delivers pressure through a nasal interface, is a best option, improving CO2 washout and reducing oxygen requirements. The settings should be according to baby requirements. Medications like surfactant and caffeine are important adjuncts. The three important medications which should be administered carefully.
- Key takeaways are stabilizing the baby early with non-invasive support, continuing supportive care, and monitoring the baby's respiratory distress with scoring systems. Individualized settings, proper care, optimal pressure, and judicious medication use are crucial for successful non-invasive respiratory support in newborns. It is important to remember do no harm.
Contoh Sertifikat
Tentang Pembicara
Dr.Avinash Kumar
Consultant Neonatologist Founder and Director - A K POCUS
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