A neonatal ventilator is a medical device used in neonatal intensive care units (NICU) to assist newborns in maintaining proper blood gas levels. Although ventilation refers to the removal of carbon dioxide from the blood, these devices also help deliver oxygen to the infant. These devices are typically used with premature babies whose lungs have not fully developed, but can also treat full-term newborns who have breathing problems. Neonatal ventilators take a variety of forms, but all are usually short-term treatments until the the lungs are capable of regulating blood gasses properly.
Infants have variable ventilation needs based on their lung function and maturity. Ventilation is reduced and removed as the lungs become more capable of supporting proper blood gas levels through spontaneous breathing. The type of neonatal ventilator used in a NICU varies based on availability and the goals of ventilation.
Positive pressure ventilators, which rely on the infant's regular lung function, are the most commonly used. This device uses a tube inserted into the airways and acts similarly to a continuous positive airway pressure (CPAP) machine used to treat sleep apnea in adults. This type of ventilator synchronizes with infant breathing patterns to exchange blood gasses. These devices are ineffective if they fail to synchronize with the newborn's respiratory rhythm, as they may deliver oxygen during exhalation. Thus, most newer versions have sensors to determine the breathing pattern.
Volume ventilators, sometimes called tidal ventilators, are another type of neonatal ventilator device. This ventilator delivers a predetermined volume of gasses at regular intervals through a tube in the infant's nose or mouth. Ventilation devices of this kind are often used in full-term infants or in the wake of surgical procedures, but most models deliver too much tidal volume of gasses for premature babies. This device relies on the lung's ability to expand and collapse as it delivers gasses.
A baby that does not improve from a traditional neonatal ventilator may be placed on a high-frequency ventilator. It may also be a first option in cases of extreme prematurity, since more conventional mechanical ventilation may harm the development of the lungs. The high-frequency ventilation method forces gasses into the lungs rather than waiting for the infant to take a breath. This form of neonatal ventilator should be used if the newborn does not take spontaneous breaths. As the lungs mature and breathing function increases, the baby may be switched to one of the other neonatal ventilator devices.
All neonatal ventilators must be carefully monitored and maintained. A breathing device may be harmful if it is not working properly or is exchanging gasses at the wrong time. It is also possible to over-ventilate an infant with these devices, which may lead to chemical imbalances such as alkalosis.
