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    Neonatal Ventilator Vent Set-Up Cheatsheet

    Uploaded by

    Rick Frea
    So you work for a small town hospital and don't set up vents on baby's very often. Well, don't fret. Now you can just look at your cheat sheet and dial in the needed values.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd

    Neonatal Ventilator Vent Set-Up Cheatsheet

    Uploaded by

    Rick Frea
    5K views1 page
    So you work for a small town hospital and don't set up vents on baby's very often. Well, don't fret. Now you can just look at your cheat sheet and dial in the needed values.

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    neonatal ventilator vent set-up cheatsheet

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    So you work for a small town hospital and don't set up vents on baby's very often. Well, don't fret. Now you can just look at your cheat sheet and dial in the needed values.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    5K views1 page

    Neonatal Ventilator Vent Set-Up Cheatsheet

    Uploaded by

    Rick Frea
    So you work for a small town hospital and don't set up vents on baby's very often. Well, don't fret. Now you can just look at your cheat sheet and dial in the needed values.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    of 1

    Guidelines for setting up Servo 300A as a Neonatal Ventilator:

    1. Pt range: Neonate (Maximum VT = 40cc)


    2. Mode: Pressure Control (works best for un-cuffed ETT)
    3. VT: a. <33 weeks gestation 4 – 6 cc/kg
    b. >33 weeks gestation or chronic 5 – 7 cc/kg
    4. PIP: a. Maximum PIP settings:
    - <27 weeks gestation 24 CWP
    - 27 – 32 weeks gestation 26 CWP
    - 33 – 40 weeks gestation 28 CWP
    b. Start low (best to err on low side to prevent barotraumas.)
    c. Increase to obtain target VT and adequate chest rise
    d. Frequently monitor & adjust PIP to accommodate
    changes in lung compliance altering tidal volume.
    5. PEEP: a. Start at minimum 4 – 5 CWP
    b. Increase to 6 – 7 CWP if FiO2 needs > 60%
    c. Adjust to maintain acceptable PaO2 and SpO2
    d. 8 – 10 CWP PEEP if directed by physician
    e. Remember that PC setting is “above PEEP”
    6. FiO2: a. Start low at 40%
    b. Adjust to maintain target SpO2
    c. If SaO2 < target range, FiO2 may be increased by 2–5,
    & then allowing 4 minutes for stabilization after each
    change. (consider adjustment of PIP and PEEP also.)
    d. Continue assuring AW patent, HR>100 & baby not apneic.
    e. If SaO2 > target range, FiO2 may be decreased by 2 – 5,
    allowing 4 minutes for stabilization after each change.
    f. Consider increasing PEEP prior to FiO2
    g. Maintain neonate on ROOM AIR whenever possible.
    7. Rate: a. 50 – 60 if < 34 weeks gestation or < 3 kg
    b. 40 – 50 if >34 weeks gestation or > 3 kg
    c. 30 – 40 if 40 weeks gestation; slightly higher if indicated.
    d. Watch for air trapping at rates > 40 (adjust I-time).
    8. I-time: a. Start at 0.3 plus or minus 0.5 (post-term may need more.)
    b. Neonatal initial I-time setting
    - <1kg 0.25 – 0.30 sec minimum 0.20 seconds
    - 1-2kg 0.30 – 0.40 sec minimum 0.20 seconds
    - 2-3kg 0.35 – 0.45 sec minimum 0.25 seconds
    - 3-4kg 0.40 – 0.60 sec minimum 0.30 seconds
    c. Ideally set using Flow-time graphics
    d. This alters I-time and I:E ratio
    e. Increase & decrease to reach target settings as appropriate
    f. Watch for air trapping at rates >40 in neonates >3kg;
    they may need I-time >0.40 to complete inspiration &
    prevent air trapping.
    g. If neonate using expiratory muscles, try decreasing I-time
    slightly (increasing flow).
    h. If I-time gets too short, consider switch to PRVC.
    9. I-Rise time: a. 10 if < 33 weeks gestational age
    b. >5 if >33 weeks gestational age
    c. Basically, the smaller the ETT the higher this should be to
    create laminar flow and a pseudo sign wave.
    d. Increase for bronchospasm (slow rise time, longer e-time)
    10. PIP limit: 2 – 3 > PIP (all other alarms as appropriate.)

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