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© 2020, Jaypee Brothers Medical Publishers

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First Edition: 2006

Second Edition: 2011

Third Edition: 2020

The author of this book, Pediatric and Neonatal Mechanical Ventilation, is an experienced Pediatric Intensivist with over 35 years of experience and expertise in the field of Anesthesia, Pediatrics, and Critical Care. He has been involved in training of Pediatric Intensive Care fellows 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.

Mechanical ventilation is an age old proven technology commonly used in neonates, infants, and older children in intensive care units for various indications.

It is often confusing for the pediatrician who is starting to learn regarding ventilation to keep up with various technical terms and abbreviations being used by ventilator companies and neonatologist and pediatric intensivists.

This text has been prepared with a view to be simple, practical, concise and easy-to-read for pediatricians, pediatric intensive care unit (PICU) and neonatal intensive care unit (NICU) residents and fellows using conventional mechanical ventilation for commonly seen conditions such as respiratory distress syndrome (RDS), meconium aspiration syndrome (MAS), persistent pulmonary hypertension (PPHN), pneumonia, acute respiratory distress syndrome (ARDS), asthma, and various cardiovascular and neurological conditions.

Standard terminology has been used and defined in the text for convenience of the reader. Ventilation technique specifically applicable to neonate or an older child has been indicated wherever necessary to avoid any confusion.

Some easy-to-read flow diagrams (algorithms) have been used for management of respiratory distress, rapid sequence intubation (RSI), basic mechanical ventilation, and weaning. Noninvasive ventilation modalities such as continuous positive airway pressure (CPAP), biphasic positive airway pressure (BIPAP), and high flow nasal oxygen have also been included. Newer modes such as high frequency ventilation and common ventilator graphics interpretation have also been included for the reader aspiring to learn the newer and advanced modes of ventilation. A chapter on extracorporeal membrane oxygenation has been added to make the reader familiar with technology beyond mechanical ventilation to support patients with refractory hypoxemia. A chapter on how to choose a ventilator has also been included as a guide to new units providing care to neonates and children.

It is hoped that this book would be helpful to the user in management of common conditions requiring CPAP, invasive and noninvasive mechanical ventilation in neonates and older children.

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.

I would like to thank all the contributing authors and my Neonatology, Pediatric ICU and anesthesia colleagues in India, UAE and USA for all the shared knowledge and experience. Most importantly I am deeply indebted to all my critically ill patients who needed mechanical ventilatory support to always bring me back to a humbling experience and make all of us intensivists realize how little did we know and that there is a lot more to learn in this vast field of intensive care and field of Medicine at large.

Finally I wish to thank my family for supporting all my publications whole heartedly by constant encouragement and support towards teaching and training juniors to save lives of critically ill neonates and children.

I would like to thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms Pooja Bhandari (Production Head), Ms Prerna Bajaj (Development Editor) and the publishing staff at Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their work in completing this book.fm_14