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 Essentials of
Neonatal Ventilation
Page left intentionally blank
Essentials of
Neonatal Ventilation
P.K. Rajiv
DCH, MD
Fellowship in Neonatology (Australia), Prime Hospitals and Clinics, Burjuman Centre, Dubai,
United Arab Emirates (ex Professor of Neonatology Amrita Institute of Medical Sciences,
Kochi, Kerala, India)

Dharmapuri Vidyasagar
MD, FAAP, FCCM, PhD(Hon)
Professor Emeritus Pediatrics, Division of Neonatology,
University of Illinois at Chicago, Chicago, IL, United States

Satyan Lakshminrusimha
MD, FAAP
Professor and Dennis and Nancy Marks Chair of Pediatrics, Pediatrician-in-Chief,
UC Davis Children’s Hospital, University of California, Davis, Sacramento, CA, United States

Foreword by
Richard A. Polin
MD
William T. Speck, Professor of Pediatrics, College of Physicians and Surgeons,
Columbia University, New York, NY, United States
Director, Division of Neonatology, Morgan Stanley Children’s Hospital of New York-Presbyterian,
New York, NY, United States
ELSEVIER
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Essentials of Neonatal Ventilation, 1e, P.K. Rajiv, Dharmapuri Vidyasagar,

Satyan Lakshminrusimha
Copyright © 2019 by RELX India Pvt. Ltd.
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Thouseef Ahmed, MD
Specialist Neonatologist, NMC Hospital,
Dubai, United Arab Emirates
Said A. Al-kindi, BHSc, MD,
DCH, MRCPCH, FRACP
Armed Forces Hospital, Muscat,
Sultanate of Oman
Namasivayam Ambalavanan, MD
Professor of Pediatrics, University of
Alabama at Birmingham, Birmingham,
AL, United States
K. Shreedhara Avabratha, MD,
DNB (Pediatrics)
Professor, Dept of Pediatrics, Fr.Muller
Medical College, Mangaluru, Karnataka,
India
Rakhi Balachandran, MD
Amrita Institute of Medical Sciences
and Research Centre, Amrita Vishwa
Vidyapeetham, Kochi, Kerala, India
Jeya Balaji, MD
Fellowship in Neonatology, Professor,
Department of Pediatrics and
Neonatology, Velammal Medical College
and Research Institute, Madurai, Tamil
Nadu, India
Dushyant Batra, MRCPCH
Nottingham University Hospitals NHS
Trust, Nottingham, United Kingdom
Catherine C. Beaullieu, MD
UT Health McGovern Medical School,
Houston, TX, United States
Nagamani Beligere, MD, MPH
Associate Professor, University of Illinois
Medical Center, Chicago, IL, United States
Anita Bhandari, MD
University of Pennsylvania, Children’s
Hospital of Philadelphia, Philadelphia,
PA, United States
Contributors
Vineet Bhandari, MD, DNB, DM
Professor and Division Chief, Drexel
University College of Medicine,
St. Christopher’s Hospital for Children,
Philadelphia, PA, United States
Rama Bhat, MD, FAAP
Professor Emeritus Pediatrics, University
of Illinois, Chicago, IL, United States
Manoj Biniwale, MBBS, MD,
MRCP, MRCPCH, FAAP
Keck School of Medicine of USC,
LAC+USC Medical Center, Los Angeles,
CA, United States
John P. Breinholt, III, MD
UT Health McGovern Medical School,
Houston, TX, United States
Ilia Bresesti, MD
“V. Buzzi” Children’s Hospital,
Milan, Italy
Bert Bunnell, ScD, FAIMBE
Biomedical Engineering, University of
Utah, Salt Lake City, UT, United States
Dinesh K. Chirla, MD, DM,
MRCPCH, CCST
Rainbow Children’s Hospital, Hyderabad,
Telangana, India
Swarup K. Dash, MD, DNB
Senior Neonatologist, Latifa
Women and Children Hospital,
DHA – Dubai, United Arab Emirates
Narendra Dereddy, MD, FAAP
Associate Professor, University of
Central Florida, Associate Medical
Director, Neonatology at Advent
Health Hospital for Children, Orlando,
FL, United States
Ramasubbareddy Dhanireddy,
MD
University Distinguished Professor,
Professor of Pediatrics, Obstetrics and
Gynecology, University of Tennessee
Health Science Center, Memphis,
TN, United States
Vikramaditya Dumpa, MD, FAAP
NYU Winthrop Hospital, Mineola,
NY, United States
Khaled El-Atawi, Mb.Bch, M.Sc.,
PhD, iFAAP, FRCPCH (Pediatrics)
& M.Sc. (HCM)
Consultant Neonatologist, Latifa
Women and Children Hospital,
DHA – Dubai, United Arab Emirates
Mahmoud Saleh Elhalik, MD,
DCH, ABP, FAAP, FRCPCH
Latifa Women and Children Hospital,
Dubai, United Arab Emirates
Ahmed Zakaria Elmorsy,
Mb.Bch, M.Sc. (Pediatrics)
Senior Neonatologist, Latifa Women and
Children Hospital, DHA – Dubai, United
Arab Emirates
Kimberly S. Firestone, MSc, RRT
Akron Children’s Hospital, Akron, OH,
United States
Regan E. Giesinger, MD, FRCPC
University of Iowa, Iowa City,
IA, United States
Hariram M., MD, DCH
Neonatologist and Head of Pediatrics
Fortis Hospital, Bannerghatta Road,
Bangalore, India
Helmut D. Hummler, MD, MBA
Chief Division of Neonatology,
Department of Pediatrics, Professor of
Pediatrics adj., University of Ulm, Germany
v
Contributors
Abbas Hyderi, MD, FRCPC, FAAP
University of Alberta, Stollery Children’s
Hospital, Edmonton, AB, Canada
Lucky Jain, MD, MBA
Richard W. Blumberg Professor and
Chair of Pediatrics, Chief Academic
Officer, Children’s Healthcare
of Atlanta
Jegen Kandasamy, MD
University of Alabama at Birmingham,
Birmingham, AL, United States
Martin Keszler, MD, FAAP
Professor of Pediatrics, Brown
University, Women and Infants Hospital,
Providence, RI, United States
Abrar A. Khan, MD
Latifa Women and Children Hospital,
Dubai, United Arab Emirates
Junaid Muhib Khan, MD, FRCP,
FAAF, FAAP, CMQ
Al-Rahba Hospital/Johns Hopkins
Medicine International, Abu Dhabi,
United Arab Emirates
Sai Sunil Kishore M., MD
(Pediatrics), DM (Neonatology)
Mycure Hospital, Visakhapatnam,
Andhra Pradesh, India
G. Ganesh Konduri, MD
Professor of Pediatrics and Chief
of Neonatology Division, Muma
Endowed Chair of Neonatology,
Children’s Research Institute, Medical
College of Wisconsin, Children’s
Hospital of Wisconsin, Milwaukee,
WI, United States
Mathew Kripail, MD
Neonatologist, Sultan Qaboos University
Hospital, Muscat, Oman
Raman Krishna Kumar, MD, DM
Amrita Institute of Medical Sciences
and Research Centre, Amrita Vishwa
Vidyapeetham, Kochi, Kerala, India
Praveen Kumar, DCH, MD
Associate Chair, Department of
Pediatrics, Visiting Professor of
Pediatrics, University of Illinois,
Children’s Hospital of Illinois, Peoria, IL,
United States
vi
Satyan Lakshminrusimha, MD, Srinivas Murki, MD, DM
FAAP Fernandez Hospital, Hyderabad,
Professor and Dennis and Nancy Telangana, India
Marks Chair of Pediatrics, Pediatrician
K.Y. Ashok Murthy, BE
-In-Chief, UC Davis Children’s Hospital,
Mg Director, Erkadi Medical Systems
University of California, Davis,
Sacramento, CA, United States Durga P. Naidu, MD
Children’s Heart Clinic of Louisiana,
Laurance Lequier, MD, FRCPC
Lafayette, LA, United States
Stollery Children’s Hospital, University of
Alberta, Edmonton, AB, Canada Arun Nair, MBBS, MD (Paed),
Gianluca Lista, MD, PhD DCH, MRCP, FRCPCH, FRACP
“V. Buzzi” Children’s Hospital, Waikato Hospital, Hamilton; Auckland
University, Auckland, New Zealand
Milan, Italy
Suzanne M. Lopez, MD Jayasree Nair, MD
UT Health McGovern Medical School, Assistant Professor of Pediatrics, Jacobs
Houston, TX, United States School of Medicine and Biomedical
Sciences, University at Buffalo, Buffalo,
Mohamed M A Soliman, NY, United States
MBBCh, MSc, MRCPCH, EPIC
Specialist Paediatrics and Neonatology, Elaine Neary, MD, PhD
The Hospital of Sick Kids, Toronto,
National Research Centre, Giza, Egypt
ON, Canada
Manoj N. Malviya, MBBS, MRCP
Josef Neu, MD
(UK)
Professor of Pediatrics, University
Khoula Hospital, Muscat, Sultanate
of Florida Health Shands Children’s
of Oman
Hospital, Gainesville, FL, United States
Mark C. Mammel, MD, FAAP
Donald M. Null, MD
Professor of pediatrics, University of
University of California, Davis; UC Davis
Minnesota Medical Center, Saint Paul,
Children’s Hospital, Sacramento, CA,
MN, United States
United States
Prakash Manikoth, MBBS, DCH,
Nalinikant Panigrahy, MD, DNB
MRCP (UK), FRCPCH
Rainbow Children’s Hospital, Hyderabad,
The Royal Hospital, Muscat, Sultanate
Telangana, India
of Oman
Merlin Pinto, MD
Bobby Mathew, MRCP
Fellowship in Neonatology (Canada),
Assistant Professor of Pediatrics, Jacobs
NIDCAP certified Professional, MetroHealth
School of Medicine and Biomedical
Hospital, Case Western Reserve University,
Sciences, University at Buffalo, NY,
Cleveland, OH, United States
United States
P.K. Rajiv, DCH, MD
Patrick J. McNamara, MB, BCh,
Fellowship in Neonatology (Australia),
BAO, MRCP, MRCPCH
Prime Hospitals and Clinics, Burjuman
Professor and Division Chief of
Centre, Dubai, United Arab Emirates
Neonatology, Stead Family Children’s
(ex Professor of Neonatology Amrita
Hospital, University of Iowa, Iowa City,
Institute of Medical Sciences, Kochi,
IA, United States
Kerala, India)
Rafique Memon, Md(Ped)
Aiman Rahmani, MD, MBA, FAAP
Fellowship Neonatology, Specialist
Chief Medical Officer Consultant,
Pediatrician, NMC Speciality Hospital,
Division of Neonatology, Clinical
Dubai, United Arab Emirates
Professor, Faculty of Medicine, United
Arab Emirates University, Abu Dhabi,
United Arab Emirates

Manimaran Ramani, MBBS, MD
University of Alabama at Birmingham,
Birmingham, AL, United States
Rangasamy Ramanathan, MD,
FAAP
Professor of Pediatrics at the Keck
School of Medicine and Division Chief,
Director of Neonatal Respiratory therapy
program, Program director, Neonatal
Perinatal Fellowship Program, University
of Southern California, Los Angeles,
CA, United States
P. Syamasundar Rao, MD, FAAP,
FACC, FSCAI
Professor of Pediatrics, Division of
Pediatric Cardiology, UT Health
McGovern Medical School, Houston,
TX, United States
Maura Helena Ferrari Resende,
MD
Clinical Fellow, The Hospital for Sick
Children, Toronto, ON, Canada
Rakesh Sahni, MD
Professor of Pediatrics, Columbia
University College of Physicians and
Surgeons, New York-Presbyterian
Morgan Stanley Children’s Hospital,
Columbia University Medical Center,
New York, NY, United States
Mitali Sahni, MD
Fellow in Neonatal-Perinatal Medicine,
St. Christopher’s Hospital for Children,
Drexel University College of Medicine,
Philadelphia, PA, United States
Marwa al Sayyed, MBBS, MSc
Neonatal Registrar, NMC speciality
Hospital, Dubai, United Arab Emirates
Bernard Schoonakker, MRCPCH
Nottingham University Hospitals NHS
Trust, Nottingham, United Kingdom
Craig Smith, MRCPCH
Nottingham University Hospitals NHS
Trust, Nottingham, United Kingdom
Augusto Sola, MD
Director Medico Ejecutivo, SIBEN, Por los
recién nacidos
Howard Stein, MD, FAAP
Promedica Toledo Children’s Hospital,
University of Toledo Health Science
Campus, Toledo, OH, United States
RoseMary S. Stocks, MD,
PharmD
Department of Otolaryngology,
Head and Neck Surgery, University
of Tennessee Health Sciences Center,
Memphis, TN, United States
Sreeram Subramanian, MD, DM
Consultant, Paramitha Children’s
Hospital; NEOBBC Children’s Hospital,
Hyderabad, Telangana, India
Gautham Suresh, MD, DM, MS,
FAAP
Section Head and Service Chief,
Neonatology, Professor of Pediatrics,
Texas Children’s Hospital, Baylor College
of Medicine, Houston, TX, United States
Ru-Jeng Teng, MD
Children’s Research Institute, Medical
College of Wisconsin, Children’s
Hospital of Wisconsin, Milwaukee, WI,
United States
Vikrum A. Thimmappa, MD
Department of Otolaryngology,
Head and Neck Surgery, University
of Tennessee Health Sciences Center,
Memphis, TN, United States
Jerome W. Thompson, MD, MBA
Department of Otolaryngology,
Head and Neck Surgery, University
of Tennessee Health Sciences Center,
Memphis, TN, United States
David A. Todd, FIMLS, MSc,
PhD, MBBS
Centenary Hospital, Canberra, ACT,
Australia
Contributors
Kirtikumar Upadhyay, MD, FAAP
University of Tennessee Health Science
Center, Memphis, TN, United States
Karunakar Vadlamudi, MD
Stollery Children’s Hospital, University of
Alberta, Edmonton, AB, Canada
Payam Vali, MD
University of California, Davis; UC Davis
Children’s Hospital, Sacramento, CA,
United States
Máximo Vento, MD, PhD
University and Polytechnic Hospital La Fe
Valencia, València, Spain
Sudeep Verma, MD, FNB
KIMS-Institute of cardiac Sciences,
Secunderabad-Hyderabad, Telangana,
India
Dharmapuri Vidyasagar, MD,
FAAP, FCCM, PhD(Hon)
Professor Emeritus Pediatrics, Division
of Neonatology, University of Illinois at
Chicago, Chicago, IL, United States
Koert de Waal, PhD, FRACP
John Hunter Children’s Hospital,
Newcastle, NSW, Australia
Mark F. Weems, MD, FAAP
University of Tennessee Health Science
Center, Memphis, TN, United States
Jen-Tien Wung, MD
Professor of Pediatrics, Columbia
University College of Physicians and
Surgeons, Columbia University Medical
Center, New York, NY, United States
Hakam Yaseen, MD, CES (Paed),
DUN (Neonat) [France], CCST
(UK), FRCPCH [UK]
University of Sharjah, Medical Director
(CMO), University Hospital Sharjah
(UHS), Sharjah, United Arab Emirates
vii
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Since the late 1960s, there has been considerable debate
about the best way to provide respiratory support for
preterm infants with RDS. Early attempts to ventilate
infants met with limited success and survivors often
suffered from chronic lung disease. In the early 1970s,
Gregory et al. reported success in using CPAP to care for
preterm infants with RDS; however, despite its simplic-
ity, there was little interest in using that technology. As
ventilators increased in sophistication (and complexity),
noninvasive ventilation was viewed as a modality that
could supplement invasive ventilation, but not as a pri-
mary mode. Furthermore, the randomized clinical trials
of surfactant suggested that most premature infants with
RDS should be intubated and administered surfactant.
The pendulum began to swing back toward noninvasive
ventilation in the last decade as randomized clinical trials
demonstrated that early application of CPAP was better
than routinely intubating infants and given surfactant. In
2018, the choices for respiratory support are even greater.
Not only are there newer generation of ventilators, but the
choices for noninvasive support commonly include nasal
Foreword
intermittent positive pressure ventilation and high-flow
nasal cannula. This textbook, Essentials of Neonatal Ven-
tilation, edited by Rajiv, Satyan, and Vidysagar, offers cli-
nicians a complete source for the latest developments in
respiratory care of critically ill newborn infants. This book
is a unique addition because of its comprehensive nature
and practical approach to respiratory care. The authors for
each chapter are leaders in their fields. It is noteworthy
that the book also addresses complications of mechani-
cal ventilation (e.g., bronchopulmonary dysplasia) and
includes sections on common neonatal problems, ECMO
and nursing care. The editors should be congratulated on
assembling such a wonderful book.
Richard A. Polin, MD
William T. Speck, Professor of Pediatrics,
College of Physicians and Surgeons,
Columbia University, New York, NY, United States
Director, Division of Neonatology, Morgan Stanley
Children’s Hospital of New York-Presbyterian, New York,
NY, United States
ix
Page left intentionally blank

The evolution of assisted ventilation in newborn intensive
care has made a unique paradigm shift. Noninvasive ven-
tilation, a significant milestone in the 1970s, has made a
comeback in the current decade. Newer methods of syn-
chronization, gentle ventilation, and permissive hyper-
capnia using both invasive and noninvasive modes are
the standard of care in neonatal intensive care today. This
book is a Herculean attempt to standardize and optimize
ventilatory care at the bedside. Each chapter is written by
international experts in the field, hoping to ignite a path
to the successful resolution of the pulmonary dysfunction,
without lung and brain morbidity. Technologies of promise
of the future are incorporated, and noninvasive monitoring
and assessment are given significant emphasis. The neona-
tal intensivist is currently exposed to a huge arena of ever-
evolving technologies. The bedside practitioner will find
this book helpful in knowing the benefits and limitations
of these technologies and support neonatal gas exchange
without compromising neurodevelopmental outcome.
More advanced technology is not always better. Sim-
ple techniques such as nasal CPAP with noninvasive
Preface
monitoring have great outcomes in preterm and term
infants with lung injury. This book gives great emphasis to
this basic technology.
The chapters are designed to evolve from the basics to
applied physiology and graduate through the assisted venti-
lation technologies. A section on cardiac issues in respiratory
care, nutritional support, and ancillary care is deliberately
magnified for the intensivist to manage accurately and objec-
tively a critical neonate with respiratory distress.
This book with E-Book facilities of videos on critical
chapters supplemented by lecture presentations would
prove to be a handy and reliable bedside companion for all
NICUs all over the world. The presentations and illustra-
tions are provided to assist in education of a new genera-
tion of neonatal providers. We gratefully acknowledge the
authors for contributing to these chapters, and providing
videos and illustrations to enhance the book.
P.K. Rajiv
Dharmapuri Vidyasagar
Satyan Lakshminrusimha
xi
Page left intentionally blank
 Acknowledgments
Rajiv gratefully acknowledges the didactic teaching of his
fellow teacher Dr. Elizabeth John, whose extreme sensitivi-
ties to the adjustment of CPAP up or down still ring a bell
in his ears. This singular caution to optimize continuous
positive airway pressure or positive end-expiratory pressure
laid the foundation of his strategy in any critical lung dis-
ease. This was the fulcrum of his success in neonatal venti-
lation in the last 30 years.
Rajiv acknowledges the heartfelt help of his teachers
Dr. Vidyasagar, Dr. Georg Simbrunner, Dr. Ramanathan,
Dr. Martin Keszler, and Dr. Dhanireddy for teaching him
and for being authors of many chapters and reviewing
many more of them. Dr. Vidyasagar was the first to agree
to the concept of this book many years ago and has been
the guiding light in the evolution of this book. Rajiv’s close
associates Dr. Prakash, Dr. Arun, and Dr. David Todd gave
him exceptional chapters at a short notice. His junior asso-
ciates Dr. Nalinikant and Dr. Srinivas provided very unique,
well-researched chapters. He is indebted to coeditor Satyan
who joined the team in 2016 for his immortal illustrations
and editorial stewardship. His illustrations offer an addi-
tional tool for neonatal providers to educate students and
parents.
Rajiv also thanks his team members Iftekar, Jason, and
Sherly for uncompromising secretarial and artwork. He
further thanks Dr. Karunakar, his associate, for respond-
ing to the perennial demands of perfection of the chapters,
without any hesitation.
This book is a unique joint effort of a highly talented
provider-publisher team. Last but not the least, Rajiv thanks
his wife Bindoo for silently bearing with him all the time-
less lapses at home while he was playing Archimedes for
the development of this book.
Dr. Vidyasagar gratefully acknowledges his men-
tors, Dr. Thomas Boggs, Dr. Jack Downes, and Dr. Victor
Chernick who introduced him to neonatal ventilation.
He thanks his wife Dr. Nagamani Beligere for her support
all through his career. His children Sahana, Sadhana, and
Sanjay and grandchildren Kavi, Anika, and Maaya have
been the source of his energy.
Satyan thanks his children (Ananya, Aniruddha, and
Arun for posing as models during their neonatal period for
his illustrations) and his wife Veena Manja, MD, MSc, for
her unrelenting support. He expresses gratitude to his par-
ents, sisters, parents-in-law, teachers, and mentors for sup-
porting and guiding him throughout his career.
All the editors sincerely appreciate the exceptional
support by Mr. Ayan Dhar and Ms. Sheenam Aggarwal at
Elsevier India. Above all, the editors are thankful to all the
babies and their parents who contributed to our under-
standing of neonatal physiology and the functioning of
assisted ventilation.
P.K. Rajiv
Dharmapuri Vidyasagar
Satyan Lakshminrusimha
xiii
Page left intentionally blank
 Contents

Contributors ....................................................... v Section III: Applied Physiology,

Foreword ............................................................ ix and Ventilator Support: General
Preface ................................................................ xi Considerations
Acknowledgment.............................................xiii

6. Introduction to Lung Mechanics.................53

Section I: Introduction and History Jegen Kandasamy,
of Ventilation Namasivayam Ambalavanan
7. Genesis of Lung Injury..................................69
1. Introduction.....................................................3 Mitali Sahni, Vineet Bhandari
P.K. Rajiv, Dharmapuri Vidyasagar, 8. Hypoxic Respiratory Failure........................81
Satyan Lakshminrusimha Praveen Kumar
2. Evolution of Neonatal Ventilation 9A. Comparison of Ventilators.........................102
a Retrospective View.......................................5 Augusto Sola
Dharmapuri Vidyasagar 9B. The Importance of Heating and Humidifying
the Inspired Gases During Mechanical
Section II: Lung Development Ventilation: Identifying the Ideal Settings
and Interventions in the Prenatal and Circuit Configuration During
and Perinatal Period Ventilation....................................................113
David A. Todd, K.Y. Ashok Murthy, P.K. Rajiv
3.Pathophysiology of Fetal Lung 10. Ventilator Graphics.....................................124
Development..................................................19 Manoj Biniwale, Rangasamy Ramanathan,
Bobby Mathew, Lucky Jain, Mark C. Mammel
Satyan Lakshminrusimha 11A. Initiation of Mechanical Ventilation.........143
4. Transition in the Delivery Room: Dushyant Batra, Craig Smith,
Current NRP Recommendations................31 Bernard Schoonakker
Máximo Vento 11B. Deterioration on the Ventilator.................149
5. Sustained Lung Inflation...............................45 Craig Smith, Dushyant Batra,
Gianluca Lista, Ilia Bresesti Bernard Schoonakker
: SLI

xv
Contents

12. Extubation....................................................155 18A. Continuous Positive Airway

Craig Smith, Dushyant Batra, Pressure for Respiratory Failure in
Bernard Schoonakker Newborn Infants..........................................280
Rakesh Sahni, Jen-Tien Wung
Complications of Ventilation
CPAP
13A. Complications of Mechanical
CPAP on 480gm premie
Ventilation....................................................161
18B. Continuous Positive Airway Pressure
Srinivas Murki, Sai Sunil Kishore,
in the Treatment of Meconium
Sreeram Subramanian
Aspiration Syndrome..................................292
13B. Pulmonary Air Leaks..................................170
Rakesh Sahni, Jen-Tien Wung
Nalinikant Panigrahy,
19. Nasal Intermittent Positive Pressure
Dinesh Kumar Chirla, P.K. Rajiv
Ventilation....................................................296
13C. Pulmonary Edema and Pulmonary
Vikramaditya Dumpa, Vineet Bhandari
Hemorrhage..................................................193
NIPPV RAM Cannula
Srinivas Murki, Sreeram Subramanian
20A. High Frequency Ventilation.......................306
13D. Neonatal Necrotizing Tracheobronchitis.....197
Payam Vali, Donald M. Null
Arun Nair, P.K. Rajiv, Aiman Rahmani
20B. High-Frequency Oscillatory Ventilation
Management Strategy..................................316
Section IV: Bedside Application Dushyant Batra, Craig Smith,
Principles of Assisted Ventilation Bernard Schoonakker, P.K. Rajiv
Devices 20C. High-Frequency Jet Ventilation: Guide
to Patient Management...............................325
14. Various Modes of Mechanical J. Bert Bunnell
Ventilation....................................................205 21. Pulmonary Vasodilators in the Treatment
Gianluca Lista, Ilia Bresesti of Persistent Pulmonary Hypertension
15A. Patient-Triggered Ventilation: Synchronized of the Newborn............................................330
Intermittent Mandatory Ventilation Ru-Jeng Teng, G. Ganesh Konduri
(SIMV), Assist–Control, Pressure-Support 22. Extracorporeal Membrane Oxygenation
Ventilation (PSV), Neurally Adjusted for Refractory Respiratory Failure.............349
Ventilatory Assist (NAVA)..........................215 Laurance Lequier, Karunakar Vadlamudi
Helmut Hummler
15B. Neurally Adjusted Ventilatory
Section V: Clinical Management
Assist (NAVA) in Neonates........................227
Howard Stein, Kimberly S. Firestone
23. Principles of Mechanical Ventilation
16. Volume-Targeted and Volume-Controlled
and Strategies of Ventilatory Support
Ventilation....................................................238
in Neonatal Lung Disease...........................365
Martin Keszler
Manimaran Ramani,
17. Noninvasive Ventilation and High-Flow
Namasivayam Ambalavanan
Nasal Cannula..............................................250
24. Respiratory Distress Syndrome
Rangasamy Ramanathan, Manoj Biniwale
and Surfactant Therapy...............................375
Nasal High Frequency ventilation
Manoj Biniwale, Rangasamy Ramanathan
xvi
 Contents

25A. Meconium Aspiration Syndrome—Part 1: 30C. Cyanotic Heart Disease in a Neonate........621

Epidemiology, Pathophysiology, Signs Rakhi Balachandran, Karunakar Vadlamudi,
and Symptoms, and Diagnosis...................413 Raman Krishna Kumar
Rama Bhat, Dharmapuri Vidyasagar 30D. Neonatal Arrhythmias................................633
25B. Meconium Aspiration Syndrome—Part 2: Sudeep Verma, Karunakar Vadlamudi,
Clinical Management..................................423 Mathew Kripail, Hariram Malakunte
Mark F. Weems, Ramasubbareddy Dhanireddy
Management of Shock
26. Persistent Pulmonary Hypertension
31A. Neonatal Shock Management....................656
of the Newborn (PPHN).............................444
Abbas Hyderi, Jeya Balaji,
Satyan Lakshminrusimha, P.K. Rajiv
Karunakar Vadlamudi
27. Bronchopulmonary Dysplasia...................461
31B. Hypotension and Shock in Preterm
Vineet Bhandari, Anita Bhandari,
Newborns......................................................679
P.K. Rajiv
Merlin Pinto, P.K. Rajiv, Jeya Balaji,
28. Congenital Diaphragmatic Hernia............491
Thouseef Ahmed
Jayasree Nair, Satyan Lakshminrusimha
31C. Hypotension and Poor Circulation
29. Care of Extremely Low Birth Weight
in Neonates...................................................689
Infants............................................................512
Koert de Waal
Narendra Dereddy, Kirtikumar Upadhyay,
Ramasubbareddy Dhanireddy Section VII: Ancillary Services

Section VI: Cardiac Issues in

32. Monitoring of Gas Exchange in
Neonatal Respiratory Care
the NICU......................................................699
Bobby Mathew, Junaid Muhib Khan,
30A. Echocardiography and Satyan Lakshminrusimha
Hemodynamics.............................................547 33. Nursing Care and Endotracheal
Regan E. Giesinger, Maura H.F. Resende, Suction..........................................................722
Elaine Neary, Patrick J. McNamara Prakash Manikoth, Manoj N. Malviya,
LV hypertrophy Said A Al-Kindi
PDA Noninvasive Nasopharyngeal Suctioning
Assessment Closed Endotracheal Suctioning
Pulmonary Hypertension on Echocardiography Open Endotracheal Suctioning
RV Dysfunction 34. Neonatal Airway Management..................747
30B. Patent Ductus Arteriosus............................585 Vikrum A. Thimmappa,
Durga P. Naidu, John P. Breinholt III, Ramasubbareddy Dhanireddy,
P. Syamasundar Rao RoseMary S. Stocks, Jerome W. Thompson
Pre PDA closure Neonatal Airway Pathology
MMVP implant PDA Closure 35. Ventilator-Associated Pneumonia
AVP II implant PDA Closure and Infection Control..................................765
MMVP Release PDA Manoj N. Malviya, Prakash Manikoth,
AVP Release PDA Hakam Yaseen

xvii
Contents

36. Nutrition in the Preterm Neonate 39. Management of Ethical Challenges

Requiring Respiratory Support..................785 in Neonatal Intensive Care.........................836
Mahmoud Saleh Elhalik, Josef Neu, Gautham Suresh
Abrar Ahmed Khan, Swarup Kumar Dash 40. Normal Reference Values...........................843
37A. Neonatal Procedures Involving K. Shreedhara Avabratha, P.K. Rajiv,
Catheters and Tubes....................................803 Mohamed Soliman M, Marwa al Sayyed,
Khaled El-Atawi, Swarup Kumar Dash, Rafique Memon, Karunakar Vadlamudi
Ahmed Zakaria Elmorsy
37B. Neonatal Limb Ischemia Due to Arterial
Online supplementary materials
Catheters.......................................................819
Catherine C. Beaullieu, Suzanne M. Lopez,
Please visit MedEnact (https://www.medenact.com/Home)
P. Syamasundar Rao to access the videos and lecture PPTs.

Section VIII: General Issues

38. Neonatal Developmental Follow-Up

Program........................................................829
Nagamani Beligere

xviii
 Section | I |
Introduction and History of Ventilation

1 Introduction 3
2 Evolution of Neonatal Ventilation
a Retrospective View 5
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