Ventilatory support of the newborn

Respiratory disorders are a frequent cause of admission in the newborn. Respiratory diseases have unique physiologic, a n a t o m i c a n d c l i n i c a l characteristics during this period necessitating special management. K n o w l e d g e o f t h e pathophysiology of pulmonary diseases and their differential impact on the lungs of differing stages of maturity is essential to the safe and efficacious applications of special techniques of treatment. Principles of respiratory management include establishment of the airway, ensuring oxygenation, assisted ventilation, assessing adequacy of vent i l a t ion, cor r e c t ion of metabolic abnormalities and alleviation of cause of distress. The goal of treatment is safe and effective assistance to oxygen delivery and carbon dioxide removal from the tissues. Inspired oxygen should be administered in a controlled manner to provide adequate but not excessive blood oxygen tension levels. Mechanical ventilation may be required to treat metabolic abnormalities. There is the need for continuous monitoring and re- evaluation. This article is intended to present an overview of the embryology of the respiratory system, pulmonary physiology in the newborn, the principles of oxygen therapy and mechanical ventilation. It also discusses the complications that can follow.