Pedia.SuiteNeonatal Tools

Resuscitation · NRP

PPV Initial Settings

Starting values for positive-pressure ventilation of the newborn — PIP, PEEP, rate and FiO₂ — per the NRP 9th Edition algorithm.

Gestational age

PIP (starting)
20–25cm H₂O
Term may need 30–40 for the first few breaths.
PEEP
5cm H₂O
Continuous throughout PPV.
Rate
40–60/min
"Breathe – two – three – breathe – two – three."
Starting FiO₂
21%
Room air. Titrate to preductal SpO₂ target.

If chest is not moving after 15 seconds of PPV

  1. MR SOPA corrective steps in order:
    • Mask adjustment
    • Reposition airway (sniffing)
    • Suction mouth then nose
    • Open the mouth slightly
    • Pressure increase (↑ PIP in 5 cm H₂O steps, max ~40)
    • Airway alternative (LMA or ETT)
  2. Reassess chest rise and heart rate after each pair (MR, then SO, then PA).

FiO₂ escalation

Below SpO₂ target↑ FiO₂ in 10% steps
Above SpO₂ target↓ FiO₂ in 10% steps
Chest compressions started100% FiO₂
HR > 100 & target reachedWean FiO₂

See preductal SpO₂ targets by minute of life →

Clinical decision support only. Starting values per NRP 9th Edition. Titrate to chest rise, heart rate response and preductal SpO₂. Follow your institutional protocols. PediaSuite is an independent study aid and is not affiliated with the AAP or AHA.