ABSTRACT
Carbon dioxide is controlled by the minute ventilation, which is a product of tidal volume and the ventilatory rate. Oxygenation is controlled by the mean airway pressure. This is a function of the inspiratory time, Positive inspiratory pressure (PIP) and Positive end-expiratory pressure (PEEP). To improve oxygenation, the PIP or PEEP can be increased. Ninety-four per cent of infants with meconium aspiration syndrome survive to discharge. This is in comparison with 79% of those with persistent pulmonary hypertension of the newborn, 75% with sepsis and 54% with congenital diaphragmatic hernia. Extracorporeal membrane oxygenation (ECMO) can be used for infants with reversible disease. Ventilation for over 14 days is considered a contraindication because of the irreversible lung damage that will have occurred, whatever the underlying pathology. ECMO is used to 'rest' the lungs while the underlying pathology recovers. Patients are placed on a cardiopulmonary bypass circuit to provide oxygenation and Carbon dioxide removal.
