Monitoring response and gastric decompression during neonatal ventilation
THE CONTEXT
During positive pressure ventilation, clinical improvement and adequate chest rise guide reassessment, while gastric distension can impair ventilation.
Assessing the response
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Improvement is indicated by an increasing heart rate, spontaneous respiration, and improving color.
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If the infant does not improve, check for chest rise. Inadequate chest rise requires ventilation corrective steps.
Gastric distension and decompression
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Positive pressure ventilation can force gas through the esophagus into the stomach, causing abdominal distension.
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A distended stomach presses on the diaphragm and compromises ventilation.
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If ventilation continues for more than two minutes, insert a 6–8 Fr orogastric feeding tube and leave it open to decompress the abdomen.