Modern Anesthesia Ventilators and the Pediatric Patient Topics: Controlled Modes of Ventilation Supported Modes of Ventilation Respiratory Monitoring to Optimize Ventilator Strategy Faculty: Jeff Feldman, MD The Children’s Hospital of Philadelphia

Mechanical ventilation of pediatric patients in the operating room can be challenging. Even small changes in delivered volume can be a significant percentage of the desired volume and lead to unintended hyperor hypoventilation, or even barotrauma. Modern anesthesia ventilators offer a selection of ventilation modes that approach the capabilities of an intensive care ventilator. Although the ICU experience can be helpful to guide the use of these modern anesthesia ventilators, clinical problems in the operating room are different from those in the ICU. Effective use of the modern anesthesia ventilator requires a clear understanding of the advantages and disadvantages of the available ventilation modes for solving the ventilation challenges which confront the pediatric anesthetist. Optimizing the ventilation strategy for an individual patient requires effective use of bedside respiratory monitoring technology. The following information will review the use of both controlled and supported modes of ventilation for the anesthetized pediatric patient. An approach to using respiratory monitors to optimize the ventilation strategy is also discussed.