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

In the context of a preterm neonate displaying significant respiratory effort, increasing the respiratory rate is an appropriate ventilator adjustment. This adjustment helps to ensure adequate ventilation by allowing for more breaths per minute, which can enhance gas exchange and decrease the work of breathing for the neonate. Preterm infants often have underdeveloped lungs and may struggle with effective gas exchange, so a higher respiratory rate can support their physiological need for increased oxygen and removal of carbon dioxide, particularly when they are exhibiting signs of respiratory distress.

By increasing the respiratory rate, the ventilator can help match the neonate's increased work of breathing and promote improved oxygen delivery and carbon dioxide clearance. This adjustment aligns with the understanding that preterm infants frequently exhibit rapid breathing patterns when they are distressed, and providing mechanical support that accommodates or augments their efforts can optimize their respiratory status.

Other options could potentially worsen the situation or are not as effective in responding to significant respiratory effort. For instance, decreasing inspiratory time might limit the amount of air delivered during each breath, which could be counterproductive in the presence of respiratory distress. Increasing tidal volume could lead to alveolar overdistension or volutrauma in these vulnerable infants. Reducing PEEP (Positive End-Expiratory