Introduction:
Newborns who are unwell or still developing may require breathing support from ventilators. In addition, babies who are ill or premature frequently have breathing problems. A mechanical ventilator is a device that breathes for infants (or adults) who cannot do so on their own. The settings of mechanical ventilators are connected to breathing tubes inserted into newborns' trachea (air pipe). It is frequently required in premature babies.
What Are the Types of Mechanical Ventilation?
Modern mechanical ventilators use positive pressure to force air into the lungs. Invasive or non-invasive positive pressure breathing is possible. Depending upon it, it is of two types as follows:
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Invasive Mechanical Ventilation- This indicates that a ventilator is attached to a tube in the airway. This tube can enter the mouth (intubation) or throat (tracheostomy).
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Non-invasive Ventilation - This technique involves using a ventilator and a face mask. The ventilator forces the lungs. Devices like CPAP or BiPAP, which a person can use at home, are examples of noninvasive ventilation methods.
What Is the Use of Mechanical Ventilation?
When a sick or premature baby needs assistance in breathing, the mechanical ventilator is hooked to the tube inserted into the windpipe (trachea). Healthcare professionals can modify the ventilator as necessary. Adjustments are made according to the baby's condition, blood gas readings, and X-rays.
What Are the Steps of Mechanical Ventilation?
Healthcare providers will perform extra operations while a baby is on a ventilator to treat or avoid complications. These are as follows:
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Monitoring- To track the body's functioning, the healthcare provider will attach a baby to different machines to monitor blood pressure, heartbeat, breathing rate (how many breaths take per minute), and oxygen content. Additionally, doctors can use chest X-rays to examine the lungs or blood tests to measure oxygen and carbon dioxide levels.
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Suctioning- Maintaining the clarity of the airways requires suctioning. Family members may find it uncomfortable to witness. To assist in clearing mucus from the breathing tube, a medical professional will implant a catheter (a tiny tube).
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Medications- The doctor might administer aerosolized (spray) medication through the breathing tube. The best approach to taking these medications is inhaling them right into the lungs' airways. Additionally, the healthcare professional will administer medication via an IV (intravenous) route.
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Nutrition- When a child is intubated and using a ventilator, they can not drink milk as they typically do. The healthcare professional will administer liquid to the baby via a tube that passes through the nose and into the stomach. The baby will receive fluids via an intravenous tube inserted into a vein.
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Mobilization- The doctors sometimes do slight mobilization in babies.
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Bronchoscopy- Bronchoscopy is a technique doctors use to examine the lungs' airways. They put a tiny, illuminated camera into the lungs via the breathing tube. They will occasionally collect tissue or mucous samples for analysis.
Who Takes Care of the Baby on a Ventilator?
Medical professionals treat a baby in the intensive care unit (ICU) when they require mechanical ventilation. Respiratory therapists can look after the baby. To care for patients who require mechanical ventilation, the ICU's entire staff has received specialized training. Physicians specialize in critical care, pulmonology, and anesthesia. Additional staff is nurses in practice and licensed nurses.
What Are the Factors Evaluated for Mechanical Ventilation?
The neonate's condition will be evaluated for severity, response to various ventilation techniques, and weaning attempts. All of these factors can be influenced by the neonate's age, gestational age, birth weight, and the level of the unit or institution where care is being provided.
How Long Can a Baby Stay on a Ventilator?
Depending on the cause, a baby needs mechanical ventilation for a few hours or, in exceptional cases, months or years. The use of a ventilator should be as little as possible. Every day, healthcare professionals will check their abilities independently. A medical professional will move from an endotracheal tube to a tube in the neck if a baby needs to be on a ventilator for a lengthy period (about two weeks).
What Are the Risks Associated With Mechanical Ventilation?
The undeveloped state of neonatal lungs increases the risk of long-term harm.
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Pneumothorax- Most infants who require ventilator support have some sort of lung issue, including developing or ill lungs that are vulnerable to harm. The delicate air sacs (alveoli) in the lungs can occasionally become damaged when oxygen is delivered under pressure. This may result in air leaks, making it challenging for the baby's ventilator to assist with breathing. It happens most frequently when air leaks into the area between the lung and the inner chest wall. It is known as pneumothorax. Until the pneumothorax heals, this air can be expelled via a tube inserted into the area.
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Pulmonary Interstitial Emphysema- Several microscopic air pockets are discovered in the lung tissue around the air sacs. However, it typically disappears gradually on its own.
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Infection- Bacterial illnesses cause infection in the body. By introducing bacteria into the lungs, the tube in the airways can lead to diseases, including ventilator-associated pneumonia (VAP). Antibiotics are used to treat this.
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Lung Injury- The ventilator's pressure can harm the baby’s lungs.
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Lung Collapse- If a weak spot in the lung develops, a hole is developed, known as lung collapse.
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Changes in Heart and Blood Flow- The heart's functionality may be impacted if a baby uses a ventilator. The blood pressure may drop, or the heart rate may increase if the heart is not functioning properly. Even if a lot of oxygen goes into the lungs, these alterations can result in less oxygen getting to the blood (decreased perfusion).
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Bronchopulmonary Dysplasia- Itis a persistent lung disease that may occur due to ventilators. As a result, the baby’s caretaker should keep a careful eye on the child.
Conclusion:
Age, gestation, lung condition, or other underlying medical conditions of the infant, as well as the availability of skilled medical personnel in a neonatal intensive care unit (NICU), providers, or other individuals trained in ventilator use, all play important roles in the decision to use a ventilator and a ventilation strategy. Accurate patient assessment is essential for any neonatal facility to diagnose the condition and determine whether to start ventilation, change the ventilation strategy, or refer the infant to higher-level treatment based on how damaged the respiratory system may be.
Sometimes, a baby might require lifetime ventilator support; then, with the family's consent, a healthcare professional will take the tube out of the mouth. They will make a little incision and place a tube through your neck. It accelerates the process of dying. Putting someone on artificial ventilation may stop them from dying if they are unlikely to recover from their condition. However, this might lead to needless agony (discomfort). The healthcare provider will advise the family to make choices in this situation.
