Respiratory distress associated with inadequate mechanical ventilator flow response in a neonate with congenital diaphragmatic hernia

Brian K. Walsh, Nancy Craig, Peter Betit, John E. Thompson, John H. Arnold

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

The incidence of congenital diaphragmatic hernia has been reported as 0.17-0.66 per 1,000 births. Despite advances in neonatal intensive care, congenital diaphragmatic hernia is associated with high mortality and morbidity. We report a neonate who was born with a left congenital diaphragmatic hernia and underwent surgical repair. The lack of ventilator flow response and flow cycling was identified via interpretation of the ventilator graphic and clinical assessment. Presumably, the ventilator failed to respond to the patient's peak inspiratory flow demand, despite the clinician's setting the highest peak flow available. A time-cycled pressure-limited mode with adjustable peak flow rate was the only option that met the infant's flow requirement, and alleviated the respiratory distress. This clinical finding follows bench research that raises the concern that so called "cradle-to-grave" ventilators may not optimally support all neonates.

Original languageEnglish (US)
Pages (from-to)342-345
Number of pages4
JournalRespiratory care
Volume55
Issue number3
StatePublished - Mar 2010
Externally publishedYes

Keywords

  • Mechanical ventilation
  • Neonate
  • Ventilator flow

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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