Mechanical Ventilation for Neonatal Transport

Neonatal physiology differs substantially from pediatric and adult physiology, with numerous considerations relevant to mechanical ventilation. At birth, the circulation transitions from dependence on the placenta to independent pulmonary gas exchange. The neonatal airway has several anatomical issues that make it more susceptible to obstruction than children or adults. Small degrees of endotracheal tube movement for intubated infants can result in extubation. Impaired surfactant production (e.g., in prematurity) and activity (e.g., in meconium aspiration syndrome) results in poorly compliant lungs prone to atelectasis. Supplemental oxygen may be toxic, especially to preterm infants. Numerous clinical entities specific to neonates, such as congenital diaphragmatic hernia, require detailed management of mechanical ventilation.