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• Corrado Moretti 2013-06-01 Full Text Available This manuscript describes the experience of our team in developing a flow-triggered nasal respiratory support for the neonate and its related clinical applications. Although mechanical ventilation (MV via an endotracheal tube has undoubtedly led to improvement in neonatal survival in the last 40 years, the prolonged use of this technique may predispose the infant to the development of many possible complications, first of all, bronchopulmonary dysplasia (BPD.

Avoiding mechanical ventilation is thought to be a critical goal, and different modes of non invasive respiratory support may reduce the intubation rate: nasal continuous positive airway pressure (NCPAP, nasal intermittent positive pressure ventilation (NIPPV and its more advantageous form, synchronized nasal intermittent positive pressure ventilation (SNIPPV. SNIPPV was initially performed by a capsule placed on the baby’s abdomen. To overcome the disadvantages of the abdominal capsule, our team decided to create a flow-sensor that could be interposed between the nasal prongs and the Y piece.

Firstly we developed a hot-wire flow-sensor to trigger the ventilator and we showed that flow-SNIPPV can support the inspiratory effort in the post-extubation period more effectively than NCPAP. But, although accurate, the proper functioning of the hot-wire flow-sensor was easily compromised by secretions or moisture, and therefore we started to use as flow-sensor a simpler differential pressure transducer. In a following trial using the new device, we were able to demonstrate that flow-SNIPPV was more effective than conventional NCPAP in decreasing extubation failure in preterm infants who had been ventilated for respiratory distress syndrome (RDS. More recently we used flow-SNIPPV as the primary mode of ventilation, after surfactant replacement, reducing MV need and favorably affecting short-term morbidities of treated premature infants. We also successfully applied SNIPPV to treat apnea of • Perner, A; Faber, T 2006-01-01 Stroke volume variation (SVV)--as measured by the pulse contour cardiac output (PiCCO) system--predicts the cardiac output response to a fluid challenge in patients on controlled ventilation.

Whether this applies to patients on pressure support ventilation is unknown. • Nassar, Boulos S; Schmidt, Gregory A 2017-06-01 The arterial partial pressure of carbon dioxide (PaCO2) is an important parameter in critically ill, mechanically ventilated patients. How Much Does A Monster Truck Driver Make A Year. To limit invasive procedures or for more continuous monitoring of PaCO2, clinicians often rely on venous blood gases, capnography, or transcutaneous monitoring. Each of these has advantages and limitations.

Central venous Pco2 allows accurate estimation of PaCO2, differing from it by an amount described by the Fick principle. As long as cardiac output is relatively normal, central venous Pco2 exceeds the arterial value by approximately 4 mm Hg.

In contrast, peripheral venous Pco2 is a poor predictor of PaCO2, and we do not recommend using peripheral venous Pco2 in this manner. Scanfont 5 Mac Serial here. Capnography offers measurement of the end-tidal Pco2 (PetCO2), a value that is close to PaCO2 when the lung is healthy. It has the advantage of being noninvasive and continuously available. In mechanically ventilated patients with lung disease, however, PetCO2 often differs from PaCO2, sometimes by a large degree, often seriously underestimating the arterial value. Hei Standards For Steam Surface Condensers 11th Edition here. Dependence of PetCO2 on alveolar dead space and ventilator expiratory time limits its value to predict PaCO2.