Lesson 1Noninvasive respiratory support modalities: nasal CPAP, NIPPV, HFNC—settings, interfaces, and contraindications in 29‑week infantsThis part describes non-cutting breathing aids for very early babies, covering nose CPAP, nose pressure breaths, and high flow nose tube, with focus on levels, fittings, no-go signs, and real uses in 29-week ones.
Nasal CPAP: pressure settings and titrationNIPPV: indications and synchronization optionsHigh-flow nasal cannula: flow and FiO2 limitsChoosing prongs, masks, and interface sizeContraindications and failure indicatorsSkin care and nasal injury preventionLesson 2Positive pressure ventilation technique in the delivery room: T‑piece resuscitator vs bag-mask, tidal volume targets, inspiratory time, peak inspiratory pressure guidance for small infantsThis part compares T-piece and bag-mask pressure breathing in birth room, focusing on setup, mask hold, pressure watch, and safe air amount, breath time, and top pressure aims for very early babies.
T-piece vs self-inflating bag: pros and consMask fit, positioning, and leak minimizationSetting PIP, PEEP, and inspiratory time safelyTidal volume targets and monitoring optionsAssessing chest rise and clinical responseLesson 3Monitoring respiratory support: continuous heart rate, SpO2 targeting by postnatal minutes, transcutaneous/arterial blood gases, chest radiograph interpretationThis part teaches watching breathing aid with steady heart rate and oxygen level, age-based oxygen aims, gas samples, skin gas watch, and chest x-ray reads to direct safe changes in NICU.
Continuous heart rate and ECG monitoringSpO2 targets by postnatal minute and ageTranscutaneous CO2 and oxygen monitoringArterial and capillary blood gas samplingChest radiograph signs of overdistensionRadiographic assessment of tube positionLesson 4Indications, timing, and methods for intubation in very preterm infants; premedication considerations and safest techniqueThis part details signs, time, and ways for tube breathing in very early babies, covering pre-drugs, tool picks, safest throat views, tube check, and plans to cut body upset.
Clinical indications and optimal timingChoosing tube size and depth of insertionPremedication regimens and contraindicationsDirect versus video laryngoscopy techniqueConfirming endotracheal tube placementManaging desaturation and bradycardiaLesson 5Surfactant therapy: indications, timing (early rescue vs prophylactic), dosing, administration techniques (INSURE, LISA/MIST), and expected responsesThis part checks lung fluid treatment in very early babies, covering signs, time of quick save vs front guard, amount plans, giving ways like INSURE and LISA, and awaited body and x-ray replies.
Clinical and radiographic indications for surfactantEarly rescue versus prophylactic strategiesWeight-based dosing and repeat dosing criteriaINSURE technique: steps and precautionsLISA and MIST: procedure and monitoringExpected response and nonresponse patternsLesson 6Decision framework: initial choice between CPAP, positive pressure ventilation, and intubation based on respiratory drive, heart rate, and work of breathingThis part gives a real choice plan for first aid—CPAP, pressure breaths, or tube—based on breath urge, heart rate, muscle feel, breath work, and pre-birth risks in very early birth room babies.
Assessing respiratory drive and spontaneous effortUsing heart rate and tone to guide decisionsWork of breathing and grunting evaluationWhen to start CPAP as primary supportWhen to provide brief positive pressure breathsWhen to proceed directly to intubationLesson 7Physiology of preterm lung: surfactant deficiency, compliance, pulmonary vascular resistance, and transitional circulationThis part checks early lung body workings, stressing lung fluid lack, soft bend, high air block, lung vessel block, and shift blood flow, linking to breath aid plans and harm risks.
Structural immaturity of distal airwaysSurfactant deficiency and surface tensionCompliance, resistance, and time constantsPulmonary vascular resistance in pretermsTransitional circulation and shunt patternsImplications for ventilator settingsLesson 8Complications of respiratory support in preterms: air leak, bronchopulmonary dysplasia risk factors, volutrauma/atelectrauma mitigation strategiesThis part looks at breath aid harms in early babies, covering air breaks, lung lasting harm risks, air stretch harm, fold harm, oxygen poison, and lung lasting illness, with stop, spot, and cut plans in NICU.
Pathophysiology of air leak syndromesRecognizing and managing pneumothoraxVolutrauma and atelectrauma mechanismsStrategies to limit oxygen toxicityBronchopulmonary dysplasia risk factorsLung-protective ventilation approachesLesson 9Criteria for escalation (failure of CPAP, persistent apnea/bradycardia, high oxygen/pressure requirements) and de‑escalation weaning pathwaysThis part lists signs to step up when CPAP or non-cut aid fails, like lasting no-breath, slow heart, or high oxygen needs, and steady step-down and cut paths to cut upset and lasting lung harm risk.
Defining CPAP failure in very preterm infantsApnea, bradycardia, and desaturation thresholdsOxygen and pressure limits prompting escalationTransition from CPAP to NIPPV or intubationStructured CPAP and HFNC weaning protocolsMonitoring stability during step-down
