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Guide to Neonatal Ventilation Case Study 3

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Case Study 3: High Frequency Jet Ventilation (HFJV)
  • Baby Danielle is a 23 4/7-weeks’ gestation, female infant who is DOL 2 (post-menstrual age: 23 6/7 weeks). She is intubated and on mechanical ventilation since DOB with the current diagnosis of acute RDS status post (s/p) surfactant x 2 on DOB. She has been managed on SIMV volume targeted ventilation since birth and her current settings are FiO2 0.45, rate 50/minute, volume target 5 mL/kg, PEEP 5 cm H2O, Ti 0.35 seconds. Serial ABG results are showing a persistent CO2 retention ranging from 60–70 mmHg. Also, her current chest x-ray (CXR) shows evolving pulmonary interstitial emphysema (PIE). The decision is made to place Danielle on high frequency jet ventilation (HFJV).

  • Questions
    1. What are the main principles of high frequency ventilation?
    2. What are the basic principles of HFJV?
    3. What are the clinical applications of HFJV?
    4. Based on the above scenario, what would be the rationale for choosing HFJV for Danielle at this time?


  • For more information to answer these questions refer to the following learning resources.
    • Review of High Frequency Jet Ventilation


  • Available CEU's (processing fees required)

  • About the Contributor

    AnnMarie Barber, MS, MSN, CRNP, is an NNP with over 19 years of experience practicing in the Philadelphia area. She received her BSN and Masters in Human Organization Science degrees from Villanova University and her MSN degree from the University of Pennsylvania. Since 2013 she has been a Clinical Nurse Educator for Mallinckrodt Pharmaceuticals providing expert consultation and education to neonatal clinicians regarding the diagnosis and treatment of PPHN and the utilization of inhaled nitric oxide. She has also been a speaker at several conferences and clinical meetings including the Virginia Society of Respiratory Care Conference, the Robert Wood Johnson University Respiratory Conference, and ANN's 16th National Neonatal Nurses Conference. She served on ANN's Executive Committee from 2014 to 2016.


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