What does the neonate/pediatric specialist recommend for a child on VC/SIMV ventilation who is facing increased breathing resistance?

For a child on VC/SIMV ventilation experiencing increased breathing resistance, initiating pressure support ventilation is a highly effective intervention. When a patient faces increased resistance, such as from airway obstruction or respiratory muscle fatigue, pressure support can provide additional assistance during each spontaneous breath. This reduces the work of breathing and decreases the effort required by the child to overcome breathing resistance. The added pressure during inspiration helps to ensure that tidal volumes meet the child's needs more readily, facilitating better ventilation and oxygenation.

In contrast, simply increasing the respiratory rate could lead to more rapid breaths but may not effectively address the underlying issue of resistance. Increasing the tidal volume can also lead to over-distension of the lungs, especially if compliance issues are present. Adding PEEP could help recruit collapsed alveoli and improve oxygenation, but it might not effectively counteract the increased resistance that is directly impacting the work of breathing.

Hence, initiating pressure support ventilation directly addresses the problem of increased breathing resistance by delivering support exactly when the child needs it most, making it the recommended approach in this scenario.