Pediatric and Neonatal Mechanical Ventilation Praveen Khilnani
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1Pediatric and Neonatal Mechanical Ventilation2
3Pediatric and Neonatal Mechanical Ventilation
Praveen Khilnani MD FAAP (USA) FCCM (USA) Senior Consultant Pediatric Intensivist and Pulmonologist Apollo Hospital New Delhi Foreword by RN Srivastav
4Published by
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
EMCA House, 23/23B Ansari Road, Daryaganj
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Pediatric and Neonatal Mechanical Ventilation
© 2006, Praveen Khilnani
All rights reserved. No part of this publication and Interactive CD ROM should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the author and the publisher.
This book has been published in good faith that the material provided by author is original. Every effort is made to ensure accuracy of material, but the publisher, printer and author will not be held responsible for any inadvertent error(s). In case of any dispute, all legal matters are to be settled under Delhi jurisdiction only.
First Edition: 2006
9788180617263
Typeset at JPBMP typesetting unit
Printed at Gopson Papers Ltd, A-14, Sector 60, Noida
5
to my mother
Late Shrimati Laxmi Devi Khilnani
who left for heavenly abode on May 2001.
She always knew I could do it whenever I thought I couldn't.
She was the one who tought me to always be optimistic and
hardworking.
God will take care of the rest.
Late Smt Laxmi Devi Khilnani
(19th Jan, 1930—13th May, 2001)6
7Foreword
Author of this book Pediatric and Neonatal Mechanical Ventilation is an experienced pediatric intensivist with over 20 years of experience and expertise in the field of anesthesia, pediatrics and critical care. He has been involved in training and teaching at various conferences and mechanical ventilation workshops in India as well as at an international level. The text presented is intended to be a practical resource, helpful to beginners and advanced pediatricians who are using mechanical ventilation for newborns and older children.
Prof RN Srivastav
Senior Consultant
Apollo Centre for Advanced Pediatrics
IP Apollo Hospital
New Delhi8
9Preface
As the field of pediatric critical care is growing, the need for a simple and focused text of this kind has been felt for past several years in this part of the world for pediatric mechanical ventilation. Effort has been made to present the method and issues related to mechanical ventilation of neonate, infant and the older child. Basic and some advanced modes of mechanical ventilation have been described for advanced readers, topics like high frequency ventilation, ventilator graphics and inhaled nitric oxide have also been included. Finally some commonly available ventilators and their features and utility in this part of the world have been discussed. I hope this book will be helpful to pediatricians, residents and neonatal pediatric intensivists who are beginning to work independently in an intensive care setting, or have already been involved in care of critically ill neonates and children.
Praveen Khilnani10
11Acknowledgements
Besides a description of available evidence and using my personal experience of mechanical ventilation of neonates and children for past 20 years I have taken the liberty of using the knowledge and experience of my teachers such as Prof HL Kaul (Professor of Anesthesiology, AIIMS, Delhi), Prof I David Todres (Professor of Anesthesiology and Pediatrics, Harvard University, Boston, MA), Prof William Keenan (Director of Neonatology, Glennon Children Hospital, at St Louis University, St Louis, MO), Prof Uday Devaskar (Director of Neonatology UCLA, CA), and authorities such as Dr George Gregory (CA), Dr Alan Fields (PICU, Childrens National Medical Center, Washington DC), Dr Robert Krone (PICU Boston Childrens Hospital, and Director, Harvard International, Boston, MA), Robert Kacemarek (Director Respiratory Care at Mass, General Hospital, Boston, MA) and Dr Shekhar Venkataraman (PICU, Pittsburgh Childrens Hospital, Pittsburgh, PA).
I would like to give special acknowledgement to my esteemed colleagues such as Dr S Ramesh (Anesthesiologist, Chennai), Dr Ramesh Sachdeva (PICU, Childrens Hospital of Wisconcin, Milwaukie, WI), Dr Meera Ramakrishnan (PICU, Ohio), Dr Sankaran Krishnan (Pediatric Pulmonologist, Cornell University, New York), Dr Balaramachandran (PICU, KKCT Hospital, Chennai), Dr Krishan Chugh (PICU, SGRH, Delhi), Dr S Singhi (PGIMER, Chandigarh), Dr S Udani (Hinduja Hospital, Mumbai), Dr S Ranjit (Apollo Hospital, Chennai), Dr Y Govil (KGMC, Lucknow, UP), Dr S Deopujari (Nagpur), Dr Rajesh Chawla (MICU, IP Apollo Hospital, Delhi), Dr RK Mani (MICU, IP Apollo Hospital and Delhi Heart and Lung Institute, Delhi), Dr Rajiv Uttam (PICU, IP Apollo Hospital, Delhi), Dr Anjali Kulkarni 12and Dr Vidya Gupta (Neonatology, IP Apollo Hospital, Delhi) and many other dear colleagues for constantly sharing their knowledge and experience in the field of neonatal and pediatric mechanical ventilation and providing their unconditional help with various national level pediatric ventilation workshops and CMEs.
Finally, the acknowledgement is due to my family without whose wholehearted support this task could not have been accomplished.