WHEN and HOW do we use the NEONATAL High Frequency Jet Ventilator!!!

PART II on jets!! WHEN do we USE the jet ventilator? What settings do we START babies on? What settings do we change if the gas shows an elevated C02? What about if we have a pneumothorax? What if the baby's oxygen is dropping? Should we always be using the jet for tiny premature infants? What evidence do we have? Learn the answers to all these questions in this video! PART II of our JET series.

This video was NOT sponsored.
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.
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References:
Rallis D, Ben-David D, Woo K, Robinson J, Beadles D, Bernardini L, Abdulhayoglu E, Flanigan E, Christou H. Single center experience with first-intention high-frequency jet vs. volume-targeted ventilation in extremely preterm neonates. Front Pediatr. 2024 Jan 4;11:1326668. doi: 10.3389/fped.2023.1326668. PMID: 38239592; PMCID: PMC10794594.

Elgin TG, Stanford AH, Klein JM. First intention high-frequency jet ventilation for periviable infants. Curr Opin Pediatr. (2022) 34:165–9. 10.1097/MOP.0000000000001104

Ganguly A, Makkar A, Sekar K. Volume targeted ventilation and high frequency ventilation as the primary modes of respiratory support for ELBW babies: what does the evidence say? Front Pediatr. (2020) 8:27. 10.3389/fped.2020.00027

Collins JJP, Tibboel D, de Kleer IM, Reiss IKM, Rottier RJ. The Future of Bronchopulmonary Dysplasia: Emerging Pathophysiological Concepts and Potential New Avenues of Treatment. Front Med (Lausanne). 2017 May 22;4:61. doi: 10.3389/fmed.2017.00061. PMID: 28589122; PMCID: PMC5439211.

Söderström F, Normann E, Jonsson M, Ågren J. Outcomes of a uniformly active approach to infants born at 22-24 weeks of gestation. Arch Dis Child Fetal Neonatal Ed. 2021 Jul;106(4):413-417. doi: 10.1136/archdischild-2020-320486. Epub 2021 Jan 15. PMID: 33452221.

Yanagisawa T, Nakamura T, Kokubo M. Prognosis of 22- and 23-Gestational-Week-Old Infants at Our Facility: A Retrospective Cohort Study. Am J Perinatol. 2022 Mar 11. doi: 10.1055/a-1779-4032. Epub ahead of print. PMID: 35193151.

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***TIMESTAMPS***
00:45 When do we use the jet?
05:47 Initial Settings using a jet ventilator
10:58 How to titrate jet based on clinical scenarios
11:21 How to titrate jet when CO2 too high
14:38 How to titrate jet when nfant hypoxemic
16:06 How to titrate jet when infant has a high C02 and lungs are HYPER-expanded
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*Disclaimer*: This video is intended for educational purposes only and while
we strive to give the most accurate information, errors may occur. Subsequently,
this video should not be a replacement for medical advice.

[emelyd]

Loved the video! Could you make a video on online auction while on the ventilator ?

[ssi_]

I'm in Respiratory Therapy school and your videos have been very useful! Thank you Dr!

[teresaontiveros]

Another amazing video! Thank you Dr Tala. I’m a NICU RN from California ❤

[brandontran]

Thank you for the video, it is really helping me understand the Jet better. Could you also do a video explaining the NAVA?

[RealTrueth]

I say you are reflector of goodness of God. May God bless you with His love.

[traceybell]

Can you do a video on permissive hypercapnia, please

[dainaswamy]

Another fantastic video! - from Utah, USA

[traceybell]

TYSM! UNC Hospital Level 4 NICU. NC USA.

[jodipylar-rhlf]

Corewell-beaumont East hospital, Michigan, USA

[shivampatel]

Great video . Saying hi from UCLA medical center .

[Chris-dinl]

QUESTION: whats the difference between a jet with sigh breaths and the VDR?

[countermeasuresecurityengi]

Evanston Hospital, ISCU Respiratory Care - IL
We utilize all - conventional vents, HFJV & HFOV. (w/ or w/o iNO)
We love tiny humans.❤
Thx Dr. T!

[khairyelwerfeli]

Thank you so much ❤ never used the jet but now I feel somehow comfortable to the name
From Libya 🇱🇾 ❤

[tessreiko]

Very helpful, thank you! Primary Childrens Hospital in SLC UT, NICU level 4

[matthewleocha]

Thank you! NICU in Chester county hospital west Chester PA USA

[anachikovani]

Dr. Tala, greetings from the country of Georgia. It's my first year in neonatology residency, and you have been helping me a lot. Thank you very much.

[Lailaeightoneone]

I gave birth 10 days ago to twins born at 28 weeks. My boy in the last few days has developed a bacteria infection. The drs told me it’s Ecoli. His markers are going down with antibiotics and they will extend the antibiotic dosage to 14 days as a precautionary measure for potential meningitis.
I would like to know how he could have gotten Ecoli in a NICU unit, how common that is and how easily treatable it is? Thanks in advance

[aartimodh]

I am nicu RT from Losangeles thanks for the great video