The emotional trauma of having a sick baby has to be one of the hardest things any parent ever has to face. With all the high-tech medical equipment available these days, the experience of having a baby in an intensive care unit can be overwhelming. This web page is devoted to answering some basic questions on the Life Pulse High-Frequency "Jet" Ventilator for parents who want to delve more deeply into the care of their infant.
Our purpose for providing information to parents is to increase their understanding of high-frequency ventilation and, thus, to bring some peace of mind.
Please understand that the following information has been generalized to cover typical situations. Your child is unique and the treatment strategy used by your physician will be individualized to meet your child's specific condition. Thus, your child's physician is your most important source for information concerning the appropriate treatment and care of your child.
The Niese Family
Kelly and David Niese have quite a story to tell. Their sons, Cooper and Deacon, were born prematurely and found themselves in a NICU fighting for their lives. Kelly and David tell their story in a series of videos that offer tremendous insights into the NICU experience. Each video is around 2 minutes, and each offers compelling lessons on how to handle the highs and lows, the despair and joy, that come with life in the newborn intensive care unit. Click here or on their photo to view the videos.
Commonly Asked Questions
What is high frequency ventilation?
High frequency ventilators usually provide better gas exchange (moving oxygen in and carbon dioxide out of the lungs) using less pressure than other ventilators. They work on the principle that it is gentler to send gas in and out of the lungs by delivering smaller breaths more often. Most mechanical ventilators try to simulate normal breathing. We call these conventional ventilators. High-frequency breaths are too small to reach the air sacs (alveoli) in the lung, so we rely on diffusion to get oxygen to the alveoli and their associated blood vessels (pulmonary capillaries). Our goal is to introduce as little pressure as possible into the fragile new lungs of our little patients.
How many babies have been treated with the Life Pulse?
The Life Pulse High Frequency Ventilator was first used experimentally in 1983. After five years of clinical trials, it was approved for commercial distribution in 1988. Since that time it has been used on approximately 100,000 infants with one more baby being added to the list with every passing hour.
Why are two ventilators connected to one patient? There are three ways babies can get the gas they need while they are on the Bunnell Life Pulse:
1. The conventional ventilator provides a few large breaths to help inflate the lung as needed, and it controls the baseline pressure ("PEEP") needed to keep the lungs inflated.
2. It also provides gas for the baby whenever he/she wants to breathe on his/her own.
3. The high-frequency ventilator facilitates gas exchange with hundreds of tiny breaths per minute.
Sometimes I hear the Life Pulse skip a breath. What's going on?
Whenever the baby breathes vigorously enough to raise the pressure above the set PIP (peak inspiratory pressure) on its front panel, the Life Pulse will pause and get out of the way. Big breaths from the conventional ventilator can have the same effect. As long as the Life Pulse picks back up after the baby finishes exhaling that big breath, there is nothing to worry about.
Why do some people call the Life Pulse "The Jet"?
The Life Pulse is a high-frequency jet ventilator because gas is delivered into the patient's endotracheal tube via a little jet nozzle. We used this approach in order to get fresh gas to penetrate as deeply into the lungs as quickly as possible. It is the same reason you put a nozzle on your garden hose when you need the water to squirt faster or farther.
I overheard the clinicians say that my baby is "fighting" the ventilator. What does that mean?
When a ventilator pushes gas into a baby's lungs at a rate that approximates what the baby is trying to do itself, the baby tries to "breath" with the machine to make life easier for him/herself. If the baby is agitated, or wants more or less gas with each breath, he/she can get out of synch with the ventilator. This is referred to as "bucking" or "fighting" the ventilator.
When the Life Pulse delivers gas in little tiny breaths at rates that are much faster than the baby can breathe, babies usually don't try to fight the machine. They can breathe at their normal slower rate, taking their relatively big breaths without interfering with what the Life Pulse is trying to do. If it does come to a fight, the Life Pulse gets out of the way, by pausing occasionally, as noted in the previous question.
Why are there so many alarms on the Life Pulse, and what do they mean?
The Life Pulse uses a different philosophy than other ventilators when it comes to alarms and alarm messages. The Life Pulse alarms when it detects changes. It could indicate a change in the baby's lungs (i.e., how stiff or congested the lungs are) or in how the machine is operating. These changes can be good or bad as far as the baby is concerned. The alarm simply alerts the clinicians to the fact that something has changed.
For example, if your baby suddenly starts breathing on his/her own, that's good. However, the Life Pulse will detect this change and set off an alarm to alert the clinicians at the bedside. The clinician may use this information to reduce the support the ventilator is providing or, they may just note the change and reset the alarm limits to allow for the baby's spontaneous breathing.
Is it normal for clinicians to discuss strategies or reference an instruction manual at the bedside?
Yes. The Life Pulse in tandem with a conventional ventilator is more versatile than other ventilators. It offers clinicians more options to fine-tune the system to address specific problems or concerns. It also gives clinicians a lot of information about the patient while they are using it. Thus, you may see clinicians question each other, discuss strategies, or even reference the Operator's Manual.
There may even be times when clinicians question if the Life Pulse is working properly. In such cases, we encourage them to check the Operator's Manual or even call us on our Hotline. We are available 24-hours a day to answer questions about the Life Pulse and help clinicians devise strategies that might be more successful.
It can be very difficult at times to figure out exactly what is going on with a sick baby's lungs and how to use ventilators optimally in order to help. That is why clinicians call for x-rays, and why there are so many instruments connected to your baby. The good news is that newborn infants grow approximately over 3 new lung air sacs (alveoli) every second. If the clinicians can just help babies get oxygen in and carbon dioxide out as gently as possible, their chances of recovering usually increase every day.
How Can I Learn More?
The best way for you to get more information on the treatment of your child is to ask those people who are providing the care. While modern hospitals are extremely busy and often confusing and stressful places, the people who work there all want to make you as comfortable as possible with the work that they do. They have people that will gladly take the time to answer all your questions and explain whatever you need to know about your child's condition. Don't be afraid to ask. Don't be afraid to say, "I don't understand." The ICU is a stressful environment, but all the people who work there care about helping your baby get well as quickly as possible.
Undoubtedly the best resource for information on the care of your infant are the health care providers at your baby's hospital. However, there may be times when parents feel compelled to do additional research on their own. To aid in this endeavor we have provided the following links.
Please remember that the information contained within this web site is general, there may be variations in the treatment that your baby's physician has recommended based on individual facts and circumstances.
The Parent's Page and the related links have been posted as a public service by Bunnell, Inc. Your feedback is very important, it enables us to provide relevant information in a centralized location. Please let us know how we can improve this site to better meet the needs of parents of critically ill infants. This feedback may include links that are not listed here that were helpful to you and your family, the content and organization of Bunnell's Parent's Page, or any other suggestions you may have.
How and Why HFJV Works
Preemie Parent Alliance
Parents of Premature Babies Inc. (Preemie-L)
Premature Baby - Premature Child
Canadian Parents On-Line
For Parents of Preemies
Neonatology on the Web: Resources of Interest to Parents