What is the appropriate ventilator adjustment for a preterm neonate displaying significant respiratory effort?

The appropriate ventilator adjustment for a preterm neonate displaying significant respiratory effort is to increase the respiratory rate. This adjustment is critical because a preterm neonate may have immature respiratory systems often characterized by inadequate ventilation and challenges in maintaining proper gas exchange. When a neonate exhibits significant respiratory effort, it indicates that the infant's effort to breathe may not be sufficient to meet their metabolic demands.

Increasing the respiratory rate allows for more frequent breaths, which can enhance ventilation and improve the elimination of carbon dioxide, as well as facilitate oxygenation. This adjustment can help accommodate the neonate's increased work of breathing by providing more opportunities for effective ventilation.

Other adjustments, such as changing the tidal volume or altering inspiratory time, may not directly address the immediate need for more frequent breaths to stabilize the neonate's respiratory status. Similarly, decreasing PEEP may reduce airway pressure and compromise lung recruitment, which is counterproductive in a neonate with significant respiratory effort. In this context, increasing the respiratory rate effectively supports the neonate in overcoming their respiratory challenges.