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Mechanical ventilator - infants

Definition

A mechanical ventilator is a machine that assists with breathing. This article discusses the use of mechanical ventilators in infants.

Alternative Names

Ventilator - infants; Respirator - infants

Information

WHY IS A MECHANICAL VENTILATOR USED?

A ventilator is used to provide breathing support for ill or immature babies. Sick or premature babies are often unable to breathe well enough on their own. They may need help from a ventilator to provide "good air" (oxygen) to the lungs and to remove "bad" exhaled air (carbon dioxide).

HOW IS A MECHANICAL VENTILATOR USED?

A ventilator is a bedside machine. It is attached to the breathing tube that is placed into the windpipe (trachea) of sick babies who need help breathing. Caregivers can adjust the ventilator as needed. Adjustments are made depending on the baby's condition, blood gas measurements, and x-rays.

WHAT ARE THE RISKS OF A MECHANICAL VENTILATOR?

Most babies who need ventilator assistance have some lung problems, including immature or diseased lungs, which are at risk for injury. Sometimes, delivering oxygen under pressure can damage the fragile air sacs (alveoli) in the lungs. This can lead to air leaks, which can make it difficult for the ventilator to help the baby breathe.

  • The most common type of air leak occurs when air gets into the space between the lung and inner chest wall. This is called a pneumothorax. This air can be removed with a tube placed into the space until the pneumothorax heals.
  • A less common kind of air leak occurs when many tiny pockets of air are found in the lung tissue around the air sacs. This is called pulmonary interstitial emphysema. This air cannot be removed. However, it most often slowly goes away on its own.

Long-term damage may also occur because newborn lungs are not yet fully developed. This can lead to a form of long-term (chronic) lung disease that is called bronchopulmonary dysplasia (BPD). This is why caregivers closely monitor the baby. Caregivers will try to "wean" the baby from oxygen or decrease the ventilator settings whenever possible. How much breathing support is given will depend on the baby's needs.

References

Bancalari E, Claure N, Jain D. Neonatal respiratory therapy. In: Gleason CA, Juul SE, eds. Avery's Diseases of the Newborn. 10th ed. Philadelphia, PA: Elsevier; 2018:chap 45.

Donn SM, Sinha SK. Assisted ventilation and its complications. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 73.


Review Date: 12/13/2017
Reviewed By: Kimberly G. Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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