Respiratory failure is the most common reason a newborn requires admission to the neonatal intensive care unit. The lungs are the last major organ system to fully mature, and a wide range of conditions, from prematurity to infection to congenital lung disease, can impair a newborn's ability to breathe adequately without support. Getting respiratory support right in the neonatal period is critically important because both inadequate support and excessive ventilation carry significant risks for the developing lung and brain.
At KIMS Cuddles at KIMS Hospitals, Electronic City, the full spectrum of neonatal ventilation in Electronic City, Bengaluru, is available, from gentle non-invasive support for the mildly compromised baby to high-frequency oscillatory ventilation for the most critically ill newborns with severe respiratory failure. Our neonatal respiratory support in South Bengaluru programme is built around the principle of using the least invasive intervention that achieves the clinical goal.
Non-Invasive Ventilation
In non-invasive ventilation, the baby receives respiratory support without placing a tube into the airway. This method supports many newborns with mild to moderate respiratory distress by providing adequate oxygenation and ventilation and thus, avoids the complications associated with intubation and mechanical ventilation.
High-flow nasal cannula provides humidified oxygen and air at higher flow rates. It is different from standard nasal oxygen. The mild positive distending pressure to the airways reduces the work of breathing.
Nasal CPAP (continuous positive airway pressure) provides a constant positive pressure through nasal prongs or a mask. It keeps the alveoli open and prevents their collapse with each breath. It is the cornerstone of respiratory management in premature babies with respiratory distress syndrome and has also reduced the need for invasive ventilation in this population.
Non-invasive positive pressure ventilation goes further than CPAP by providing pressure support during inspiration, along with the baseline CPAP pressure. The ventilatory support is better than CPAP alone while still avoiding intubation.
Invasive Mechanical Ventilation
Invasive ventilation in the NICU in Electronic City is needed when non-invasive support is not adequate to maintain gas exchange. It is also needed when the condition of the baby does not allow for non-invasive support. It involves placing an endotracheal tube into the baby’s trachea, which is attached to a mechanical ventilator to supply steady breaths. It provides positive pressure throughout the respiratory cycle. Modern neonatal ventilators provide volume targeted ventilation that delivers a consistent tidal volume with each breath and reduces the risk of lung injury from over-distension. It also has synchronised modes to co-ordinate ventilator breaths with the baby’s own respiratory effort. They reduce the fighting against the ventilator that worsens lung injury.
Our team uses the ventilation mode after assessing each baby’s specific respiratory physiology and stage of illness. They also review ventilator settings and pay close attention to blood gas results and clinical response.
High-Frequency Oscillatory Ventilation
For newborns with the most severe respiratory failure, including those with congenital diaphragmatic hernia, severe respiratory distress syndrome, air leak syndromes, and pulmonary hypertension, conventional mechanical ventilation may not provide adequate gas exchange without causing unacceptable lung injury. High-frequency ventilation in newborns in Electronic City addresses this by delivering very rapid, small oscillations of gas at frequencies far above the normal breathing rate, typically between 300 and 900 oscillations per minute.
These high-frequency oscillations maintain the lung at a constant mean airway pressure, promoting alveolar recruitment, while the tiny volumes delivered with each oscillation minimise the stretch injury that conventional ventilation causes. The result is effective gas exchange at significantly lower peak pressures than conventional ventilation, protecting the fragile neonatal lung from further injury.
Our NICU at KIMS Cuddles at KIMS Hospitals, Electronic City, has specific clinical experience in high-frequency oscillatory ventilation and uses it as a primary rescue strategy for severe respiratory failure rather than only as a last resort.
Surfactant Therapy
Surfactant deficiency is the primary cause of respiratory distress syndrome in premature babies, and surfactant replacement therapy is one of the most impactful treatments available for this condition. Surfactant is delivered directly into the lungs through the endotracheal tube and rapidly improves lung compliance and oxygenation. Our team uses the newest minimally invasive surfactant delivery strategies, including LISA (less invasive surfactant administration), which allows surfactant delivery through a small catheter in a spontaneously breathing infant on CPAP, thus avoiding intubation in many cases.
Monitoring Respiratory Function
Effective respiratory support requires continuous and precise monitoring of respiratory function. Our NICU at KIMS Cuddles at KIMS Hospitals, Electronic City, uses continuous pulse oximetry, regular blood gas analysis, and respiratory function monitoring. It means they include tidal volume measurement and compliance assessment, to guide ventilator management and identify the earliest signs of improvement or deterioration.
Why Choose KIMS Cuddles at KIMS Hospitals, Electronic City
Neonatal ventilation management requires specific clinical expertise, appropriate equipment across the full spectrum of support modalities, and the clinical infrastructure to manage the complications that can arise in critically ventilated newborns. At KIMS Cuddles at KIMS Hospitals, Electronic City, our neonatal team has the experience and equipment to provide every level of respiratory support from the gentlest non-invasive intervention to high-frequency oscillatory ventilation, within a fully integrated NICU in South Bengaluru.
Book a Consultation
To discuss the respiratory support available for a critically ill newborn or to enquire about our neonatal intensive care services, contact KIMS Cuddles at KIMS Hospitals, Electronic City, online or by phone.
