Neonatal Nurse Practitioner Practice Exam

In which type of support does the pressure provided accommodate the infant's respiratory effort?

1. Assist Control

2. Pressure Support Ventilation (PSV)

3. Synchronized Intermittent Mandatory Ventilation (SIMV)

4. Nasal CPAP

The correct answer is: Pressure Support Ventilation (PSV)

Pressure Support Ventilation (PSV) is characterized by its ability to accommodate the infant's respiratory effort. In this mode of mechanical ventilation, the ventilator detects when the infant initiates a breath and then provides a preset level of pressure support during the inspiratory phase. This allows the infant to breathe spontaneously while receiving the necessary assistance to achieve greater tidal volumes without the need for continuous mandatory breaths provided by the ventilator. In PSV, the infant has the autonomy to dictate their own respiratory rate and depth, benefiting from the added pressure support that reduces the work of breathing. This approach promotes patient-ventilator synchrony and is particularly advantageous for infants who can initiate breaths but may require supplemental assistance to optimize ventilation and oxygenation. Other modes such as Assist Control and Synchronized Intermittent Mandatory Ventilation involve more controlled breathing patterns, where mandatory breaths are provided alongside the infant’s spontaneous efforts, which does not provide the same level of responsiveness to the infant's breathing efforts as seen with PSV. Nasal CPAP, while supportive for maintaining functional residual capacity and improving oxygenation, does not adapt to the respiratory efforts of the infant in the same way as PSV.