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Physiology of Positive Pressure Ventilation

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Physiology of Positive Pressure Ventilation

The goal of assisted PPV is to improve gas exchange in a newborn in need of resuscitation. Ventilation of the lung mixes inspired atmospheric gas with alveolar gas so that the partial pressure gradient drives oxygen into and carbon dioxide out of the pulmonary capillary blood. The following figure presents the normal pressure-time curve of each breath given during PPV.

Peak inspiratory pressure (PIP)corresponds to the highest pressure administered to the neonate with each breath. Plateau pressure is the air pressure applied to the alveoli at the end of inspiration. Positive end-expiratory pressure (PEEP) is the remaining pressure in the lungs between breaths. A manometer is a device that measures the pressure delivered during each breath. The manometer on a resuscitation bag or T-piece resuscitator displays the PIP and the PEEP.

The rate is the number of breaths administered per minute. The inspiratory time corresponds to the length of the inspiratory phase. Exhalation occurs during expiration, and the time of expiration corresponds to the duration of the pause between breaths.