Recorded sessions on demand will be available 24 hours after the session ends

Abstract Body

Non-invasive respiratory support (NRS) is frequently used to manage neonatal respiratory failure. Anyway NRS fails in about 50% of preterm infants that need to be intubated and mechanically ventilated. When approaching invasive ventilation it is crucial to know the ventilator and disease pathology, to develop a specific strategy for underlying pathophysiology, to change the ventilator strategy according to pathophysiology changes and always try to wean the neonate off the ventilator support. In order to reduce the risk of BPD it is important to use a lung-protective ventilation strategy and therefore to tailor the ventilation to lung mechanics changes. In the last years we have observed a progressive "evolution" in neonatal ventilators. Technological advances now permit continuous respiratory mechanics monitoring including graphic display of flow, volume and airway pressure, using a flow sensor. The clinical application of pulmonary graphics are for example: detection of inadvertent extubation, circuit leak or airway obstruction occurrence, signs of lung overdistension, inadequate lenght both of inspiratory and expiratory time, excessive respiratory rate with inadvertent PEEP, increased expiratory resistance, compliance changes, inadequate trigger sensitivity, inadequate setting of PIP to reach set tidal volume, asynchrony between ventilator and patient effort. Using pulmonary graphics we can have a better understanding of respiratory physiology, and interaction between infant and ventilator and so guarantee a tailored ventilation to reduce the risk of ventilator-induced lung injury that can predispose to BPD.