NEO: O2 administration ppt (1/9)

Goal of O2 administration

Achieve adequate tissue oxygenation targeted to meet specific patient (size, GA, clinical condition, etc.)

Evidence of hypoxemia in children vs neonates

Children: PaO2 <80mmHg, SpO2 <95%

Neonate: PaO2 <60mmHg, SpO2 <90%

Clinical signs and symptoms initially? When worsening?

Initially tachycardia + tachypnea

Worsening causes decreased ventilation, apnea, bradycardia and signs of WoB (grunting, flaring etc.)

Complications of therapeutic O2 administration (5)

1. adverse physiological effects (R→L shunt)

2. Equipment related

3. hypoventilation, atelectasis

4. retinopathy of prematurity

5. pulmonary vasodilation or fibrosis

Current practice

PaO2 50-80mmHg and SpO2 88-95% in premature neonates

What flow do you set NC at? What flow an you run 100% FiO2 at?

NC w/ flow 0.1-3.0L/min (newborns no greater than 2L/min)

Don’t give baby 100% FiO2 UNLESS on <0.5L/min

Variable performance delivery devices

1. simple O2 mask 6-10L/min (provides FiO2 0.35-0.5)

2. reservoir masks (partial, nonrebreahting masks, not recommended!)

Fixed performance delivery devices

1. air entrainment mask (controlled FiO2 on low or moderate levels)

2. air entrainment nebulizers (provides 100% body humidity)

3. HHFNC (used for apnea of prematurity)

4. O2 hood (transparent enclose but rarely used)

What happens when gas flow rates exceed inspiratory flow rates?

Gas flow rates exceeding inspiratory flow rates purge nasopharyngeal cavity during late exp phase and end-exp pause of respiration.