EC Microbiology

Introduction: Mechanical ventilation provided lifesaving support for infants with respiratory failure and improved neonatal survival, especially for preterm infants with immature lung function. There are many concepts, modes and modalities that render MV a tricky and sophisticated tool, especially for residents and physicians early in their careers. Adequate use of MV requires an understanding of basic physiologic and pathophysiologic features of respiration, gas exchange, ventilation, and lung disease as long as the available modes and modalities.

Aim of the Work: This review focuses on the indication of MV in neonate, available modes and modalities of mechanical ventilation, and the advantages and disadvantages of these modes and modalities.

Methods: We have conducted a thorough search of medical literature databases regarding mechanical ventilation in neonates. All studies until November 2020 were screened and included, when relevant.

Conclusion: There is two broad types of ventilator used in the neonatal intensive care unit (NICU): conventional mechanical ventilation (CMV) and high-frequency ventilation (HFV). Conventional mechanical ventilation could be classified by modalities to pressure-control or volume-control ventilation, and by modes to mandatory or synchronized ventilation. Either of the modalities can be used with either of modes. Pressure-limited ventilators are associated with instability in tidal volume that may harm the immature lungs of preterm. Volume-targeted ventilators is considered more advanced and safe. They are able to provide more consistent tidal volume during neonatal mechanical ventilation, which is associated with lower risk of lung injury compared with pressure-limited ventilation.

Keywords: Mechanical Ventilation; Neonate; NICU

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