Deck 17: Neonatal Mechanical Ventilation

Question 1

A randomized trial comparing two surfactants, those obtained from mammalian lungs and those that are synthetically produced, found an advantage in using synthetic surfactant.

Answer 1

False

Question 2

Recent publications have reported that N-CPAP is both feasible and effective in most very-low-birth-weight infants and those with acute respiratory failure.

Answer 2

True

Question 3

Neonatal ventilator circuits should have a high compression factor.

Answer 3

False

Question 4

The ability of HFOV to oxygenate the blood is not as good as with other methods.

Question 5

Because of the potential risks associated with ECMO, the clinical criteria used selects only those infants who are at an 80% or greater risk of mortality if conventional methods are used.

Question 6

Selection of an ETT for neonates is based on the ____ or gestational age of the neonate.

A) birth length
B) chest circumference
C) neck circumference
D) birth weight

Question 7

If the tube does not have a vocal cord marking, a rule to estimate the depth of intubation is to add the number ____ to the body weight in kilograms (kg).

A) 4
B) 5
C) 6
D) 7

Question 8

Approximately 90% of surfactant is phospholipid, with ____ comprising 85% of the total amount.

A) dipalmitoyl phosphatidylcholine
B) phosphatidylcholine
C) phosphatidylglycerol
D) phosphatidylinositol

Question 9

Which of the following common surfactants has a recommended dosage of 4 mL/kg every 6 hours up to 4 total doses in the first 48 hours?

A) Infasurf
B) Survanta
C) Exosurf
D) Curosurf

Question 10

CPAP reduces V/Q mismatch by improving ____ and reducing intrapulmonary shunting.

A) minute ventilation
B) respiratory frequency
C) functional residual capacity
D) gas exchange

Question 11

During mechanical ventilation, some of the ventilator volume is "lost" within the circuit and humidifier and is not delivered to the patient. This wasted volume is called the ____.

A) expansion volume
B) compressible volume
C) compression factor
D) compliant factor

Question 12

Ideally, the temperature of the gas at the ____ should be 37 °C with a water content of 44 mg/L.

A) epiglottis
B) vocal cords
C) esophagus
D) trachea

Question 13

Since the tidal volume (V_T) control is not available when using pressure-controlled ventilation, an estimated V_T can be calculated by multiplying the inspiratory time (I time) and ____.

A) PIP
B) I:E Ratio
C) flow rate
D) F_IO₂

Question 14

Which of the following has a suggested starting ventilation of 20 to 30 cm H₂O under low compliance conditions?

A) PIP
B) PEEP
C) flow rate
D) tidal volume

Question 15

Early studies involving ____ showed that adequate ventilation occurred even when tidal volumes far below deadspace were used.

A) HFV
B) PCV
C) dual-control ventilation
D) APRV

Question 16

HFPPV is delivered at frequencies between ____ cycles per minute.

A) 40 to 60
B) 60 to 150
C) 240 to 660
D) 480 to 1800

Question 17

The indications for using ____ include severe pulmonary disease that is complicated by air leaks, such as pulmonary interstitial emphysema (PIE), pulmonary hypoplasia, restrictive lung disease, and persistent pulmonary hypertension.

A) PRVC
B) HFOV
C) MV
D) HFJV

Question 18

____ has potential applications for use in several diseases that traditionally have been difficult to treat such as RDS, aspiration syndromes, persistent pulmonary hypertension of the newborn, and pneumonia.

A) Machine volume
B) Liquid ventilation
C) Volume guarantee
D) HFV

Question 19

Patients with ____ are excluded from consideration of ECMO.

A) ICH
B) PPHN
C) sepsis
D) MAS

Question 20

A(n) ____ of 35 to 50 mm Hg for 2 to 12 hours indicates a need for ECMO therapy.

A) P(A-a)O₂
B) PaO₂
C) OI
D) mPaw

Question 21

The SpO₂ for premature infants less than 32 weeks gestation should be maintained between 85% and 92% to minimize the incidence of _______________.

Question 22

_______________ is the method to apply airway pressure without any mechanical breaths.

Question 23

In _______________, a preset peak inspiratory pressure (PIP) is used to deliver the volume.

Question 24

A phenomenon, called _______________, occurs when inflated alveolar units equilibrate gases by swinging ventilations between them.

Question 25

The mortality rate of infants under conventional ventilator care strategies can be predicted by three methods: P(A-a)O₂, _______________, PaO₂ or pH measurements.

Question 26

What are the five indications for endotracheal intubation of a neonate?

Question 27

Explain the potential problem with heated wire circuits inside an inspiratory tubing.

Question 28

What are the three benefits of HFOV?

Question 29

What are some hazards associated with HFJV?

Question 30

What are the cardiovascular and hematologic complications associated with ECMO?