In neonatal intensive care units (NICUs), blood sampling, including arterial blood gas (ABG) tests and capillary blood tests (commonly known as a ‘heel stick’), plays an important role in patient monitoring. These tests help care teams monitor a variety of parameters, including blood pH levels and concentrations of vital gases like carbon dioxide (CO2) and oxygen (O2).

Chronic hypercapnia, characterized by elevated levels of CO2, poses a significant challenge for individuals with conditions like chronic obstructive pulmonary disease (COPD), neuromuscular disorders (NMD), and obesity. Although the negative effects of chronic hypercapnia are widely acknowledged, researchers at the University of Michigan are shedding light on the true urgency of its management.

How can NICU teams ensure that all of these priorities are adequately managed? Here, we’ll take a deeper look at NICU ventilation, the challenges that clinicians face, and strategies that can help.

Intrapulmonary percussive ventilation (IPV) therapy is an airway clearance therapy that combines percussion, high-velocity flow, and entrainment to mobilize secretions and address gas exchange impairment. The therapy can be delivered through a mouthpiece or mask, directly to the airway, or in-line with a ventilator, making it versatile for a range of patient populations.

The IPV 1 is a safe and effective airway clearance device that builds on the Percussionaire legacy of IPV therapy with a Unified Connector that supports patient safety, a patient-friendly interface, and the unique efficacy of the Phasitron.

This whitepaper discusses three pediatric patient populations that are difficult to manage on mechanical ventilation and how continuous monitoring of CO2 can serve as a powerful tool to support noninvasive ventilation (NIV) strategies and therapies in the PICU.

Along with IPV therapy’s clinical results in treating patients with respiratory complications, it has a demonstrated history of being safe and well-tolerated across diverse patient populations, care settings, and delivery interfaces.

We may not typically consider blood draws and heel sticks to be a large driver of patients losing blood, but the issue carries greater significance with neonatal patients, who don’t have much blood to give in the first place.

There is a long list of decisions to make when adopting new technology in a hospital unit, and transcutaneous monitoring is no exception. Some of the most overlooked decisions in our experience are those around mounting and storing the devices both during monitoring, while not in use, as well as for performing maintenance.

To manage the CO2, the main tool is your ventilation strategy. However, freely increasing the rate, volume, and pressure without careful consideration presents its own set of issues. The ventilation that is important to keep CO2 in a safe range for brain protection is the same ventilation that could damage the lungs.