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[Conventional mechanical ventilation in the premature infant and the full-term newborn]
Abstract:
Convention mechanical ventilation (MV) is installed after nasotracheal intubation by means of a volume generator or pressure reducer. Careful monitoring of the child's respiratory status is indispensable; sedatives and/or muscle relaxants may facilitate MV. The method is indicated in case of oxygen-resistant hypoxaemia or of global alveolar hypoventilation, or to cope with a severe general or neurological stress. While MV is being applied, there main and dangerous complications may occur: respiratory obstruction, pneumothorax and lower respiratory tract superinfection. Weaning must be progressive. As regards the practical handing of MV, the best way to adjust the respirator constants is to evaluate the time constant according to the nature of the lung disease and to the stage it has reached in its course. In the most severe situations, and particularly in case of hyaline membrane disease, one must try to obtain the best possible adequation between severity of the disease and ventilatory stress, without preestablished arbitrary limits.