paeds791

paeds791

A neonate was delivered 24 hours ago at the gestational age of 29 weeks. His birth weight was recorded to be 1 kg. Due to his critical state, the baby was intubated and ventilated. Prior to his intubation, the baby was managed with CPAP, but he seemed to get exhausted. He is now on SiMV (spontaneous intermittent mechanical ventilation). The ventilator settings are as follows: targeted tidal volume 9 ml, maximum PIP 30, PEEP 5, rate 40/min, FiO2 0.3. Baby’s oxygen saturations are 93%. Blood gas shows pH 7.41, CO2 3.9 kPa, BE -4. Which of the following changes need to be made to the ventilator settings initially?