When recording the respiratory rate of an intubated patient, the nurse should record both the rate (or frequency) the ventilator is set on and the number of breaths that the patient spontaneously initiates in one minute. This number gives the clinician information regarding the patient’s respiratory drive.

Both of the conventional ventilators in routine use in the NICU use synchronized ventilatory techniques, which can make it difficult to differentiate between patient-initiated, ventilator-assisted breaths and purely mechanical breaths. The preferred means of counting respiratory rate in the intubated patient is direct patient observation with the breaths in which the baby can be seen to contract his/her diaphragm and intercostal muscles counted as spontaneously initiated.

However, both the Draeger Evita and the Infant Star in SIMV mode provide measures of patient-initiated respiratory rate. The Draeger has a numerical display of the total respiratory rate and the patient’s spontaneous rate (f _spon) on the data screen (viewed by pressing "Measured Values"). The Draeger also provides a visual display of patient-initiated breaths, which begin as gray-colored waveforms on the graphic display screen.

The Infant Star synchronization unit reports the "spontaneous breath rate," the "synchronous assisted breath rate" and the "controlled breath rate." The patient-initiated respiratory rate is the sum of the spontaneous breath rate and the synchronous assisted breath rate. (Ensure that the SIMV probe is functioning appropriately by coordinating audible clicks with the patient’s spontaneous breaths.)

Resolved at Clinical Division Meeting 10/22/01.