[Pressure support ventilation in neonatal age: lights and shadows]

Area of Science:

• Neonatal respiratory support
• Mechanical ventilation modes
• Pediatric critical care

Context:

• Pressure Support Ventilation (PSV) is a common partial ventilatory assistance mode in neonatal intensive care units.
• PSV allows the patient, specifically newborns, to control their breathing pattern.
• It is a pressure-targeted, flow-cycled method where breaths are patient-triggered and pressure-supported.

Purpose:

• To describe the physiological effects of Pressure Support Ventilation in newborns.
• To highlight the advantages and disadvantages of PSV in neonatal care.
• To define the appropriate use cases for PSV in different neonatal patient categories.

Summary:

• PSV supports breathing by synchronizing positive pressure with the newborn's inspiratory effort.
• Physiological benefits include improved breathing patterns, enhanced gas exchange, reduced work of breathing, and better patient-ventilator interaction.
• Potential drawbacks include patient-ventilator asynchrony and the risk of alveolar hypoventilation, particularly in critically ill neonates.

Impact:

• PSV can lead to reduced respiratory rate and increased tidal volume in newborns.
• Improved alveolar ventilation and reduced work of breathing enhance respiratory muscle support.
• Effective for stable neonates, but contraindications exist for critically ill infants with compromised respiratory drive.