Use Of Ecmo Versus Conventional Ventilation Patients With Acute Respiratory Distress Syndrome

Extracorporeal membrane oxygenation, short for ECMO, is an extracorporeal system of giving both cardiovascular and respiratory support to people whose heart and lungs can't give a sufficient measure of gas exchange to maintain life. This may be from the result of recent cardiac surgery. Generally, this has been utilized on kids, yet the use in adults with heart and respiratory disorders has increased over the years. Extracorporeal is defined as occurring outside of the body. Normally after a patient experiences a lung injury they are placed on mechanical ventilation which helps push oxygen into the lungs. Sometimes lungs are so badly damaged to the point they are unable to handle the high pressures required to provide adequate oxygenation.

This assignment describes my own reflective experience while caring for a sick neonate with Respiratory Distress Syndrome (RDS) in the neonatal unit. This has enabled me to explore the meaning and significance of my clinical practice and to recognise the complexities within it. The experience raises a number of issues frequently encountered in daily nursing practice. Within this assignment, I will be discussing a particular pre term baby with RDS and critically analyse the use of nasal continuous positive airways pressure (NCPAP) and surfactant therapy and possible effects on baby’s outcome. Pseudonyms will be used to maintain patient confidentiality in order to keep in with the nursing and midwifery council code of conduct. (NMC 2004)The

The new versus classic BPD features have changed over the years. The approaches to care, including surfactant administration, permissive hypercapnia, and noninvasive ventilation have changed. All these has increased the survival of low birth weight infants as before with classic BPD. The classic BPD was before surfactant and more management techniques, and inflammation and alveolar septal fibrosis. All these changes were associated with oxygen toxicity, infection, and barotrauma.

Premature birth has been linked to a vast array of lungs problems, the earlier the birth the greater risk of health complications(Davis R and Mychaliska G, 2013). A majority of the health problems will affect the infant for the rest of their life (Davis R and Mychaliska G, 2013). Infants born between the canalicular and the saccular period (week 25) have lung development that is unsuitable for gas exchange (Davis R and Mychaliska G, 2013). Two major complications that arise with undeveloped lungs is bronchopulmonary dysplasia, and pulmonary arterial hypertension (Mahgoub L. et al. 2017).

The list of proposed chronic abnormalities is lengthy. To this date, research has confirmed the following: 1) SIDS is due to a dysfunction of the cardiac and/or respiratory systems, and 2) the death of the infant is due to hypo-ventilation of the lungs and periods of complete cessation of breathing or apnea. Hypo-ventilation and apnea cause hypo-perfusion of the tissues with necessary oxygen. Ischemia of tissues results and eventually causes death. Research now centers around discovering the cause of infant hypo-ventilation and apnea.

Respiratory therapy refers to both a subject area within clinical medicine and to a distinct health care profession. During the 20th century, there were many health care fundamental transformations. Here are 10 possible predictions of what may occur in the future of respiratory care: (1) Less focus on raising PaO2 as a primary goal in managing patients with acute hypoxemic respiratory failure. (2) More attention to

38. American Journal of Respiratory care and critical care Medicine, Volume 175, issue 7, pages 698 – 704

Karen Meunier, is the education consult for New Orleans’s Childrens Hospital Ventilator Assisted Care Program (VACP). Mrs. Meunier educated the audience on the history of ventilators. Next, Mrs. Meunier stated the criteria for the children who are enrolled in the Ventilator Assisted Care Program. Overall, these children either have a neuromuscular, brain and/or spinal cord injury, and/or birth related diagnosis. The children in the program live at home in Louisiana, under the age of 26, Medicaid eligible, and require daily mechanical support of respiratory efforts. Lastly, Mrs. Meunier informs the audience about each member in the VACP staff. The VACP staff includes an education consultant, respiratory therapist trainer, two case managers,

Although essential for survival, mechanical ventilation of preterm infants is closely associated with a high risk of developing bronchopulmonary dysplasia (BPD) (Wallace et al., 2009). Bronchopulmonary dysplasia is

Your child may be connected to a heart-lung bypass machine. This machine will provide your child with oxygen during the procedure.

ARDS is acute respiratory failure with persistent hypoxemia, decreased pulmonary compliance, dyspnea, noncardiac-associated pulmonary edema, and dense pulmonary infiltrates on the chest x-ray. The main site of injury within the lung is the alveolar-capillary membrane

Approximately 5% of infants born through MSAF develop meconium aspiration syndrome (MAS). About half or more of the affected childrens need mechanical ventilation because of MAS which is severe. It is characterised with pulmonary air leaks and the presence of persistent pulmonary hypertension. MAS is the a common disorder in which neonates are treated with extracorporeal life support. Many management stratagies exists to prevent MAS during parturition, labor, and the first minutes of life. The frequently used treatment is antenatal therapies include amnioinfusion; intrapartum maneuvers include oropharyngeal suctioning prior to delivery of the babies shoulders; the postnatal intervention of intubation for intratracheal suctioning for the non-vigorous meconium-stained

HFPV is an effective intervention strategy for patients with acute lung injury and acute respiratory distress syndrome. ALI/ARDS is characterized by altered fluid balance in the lungs and what HFPV does is it pushes the air into the lungs thereby removing the fluid that has built up in the alveoli out of the air sacs. A patient with ARDS/ALI experiences pulmonary or systemic inflammation leading to activation of alveolar macrophages and neutrophils to the lungs by cytokines and proinflammatory molecules. Leukotrienes, oxidants, platelet-activating factor, and proteases are then consecutively released damaging the capillary endothelium and alveolar epithelium. This destroys the barriers between the capillaries and airspaces. Because of this,

Nurses working within the neonatal unit require a particular set of skills to adequately fulfil their roles and responsibilities within this fragile setting. The role of a neonatal nurse is to provide intensive nursing care to an infant who has inherited complications at birth due to varied reasons (Tubs-Colley, Pickler, Younger, & Mark, 2015). These complications often manifest as undeveloped internal organs that make simple bodily functions such as breathing and regulating body temperature incredibly difficult. The neonatal nurse provides close monitoring and extremely individualized care per patient to stabilise and further develop these body systems artificially post-uterine (Drozdowicz & Dillard, 2014).

Respiratory distress syndrome (RDS) is a common lung disorder that mostly affects preterm infants. RDS is caused by insufficient surfactant production and structural immaturity of the lungs leading to alveolar collapse. Clinically, RDS presents soon after birth with tachypnea, nasal flaring, grunting, retractions, hypercapnia, and/or an oxygen need. The usual course is clinical worsening followed by recovery in 3 to 5 days as adequate surfactant production occurs. Research in the prevention and treatment of this disease has led to major improvements in the care of preterm infants with RDS and increased survival. However, RDS remains an important cause of morbidity and mortality especially in the most preterm infants. This chapter reviews the most current evidence-based management of RDS, including prevention, delivery room stabilization, respiratory management, and supportive care.