Continuous Positive Airway Pressure in New-generation Mechanical Ventilators

2002 ◽  
Vol 96 (1) ◽  
pp. 162-172 ◽  
Author(s):  
Muneyuki Takeuchi ◽  
Purris Williams ◽  
Dean Hess ◽  
Robert M. Kacmarek
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Delay Time ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Peak Flow ◽  
Pressure Change ◽  
Lung Model ◽  
Mechanical Ventilators ◽  
Pressure Time ◽  
Pressure Time Product

Background A number of new microprocessor-controlled mechanical ventilators have become available over the last few years. However, the ability of these ventilators to provide continuous positive airway pressure without imposing or performing work has never been evaluated. Methods In a spontaneously breathing lung model, the authors evaluated the Bear 1000, Drager Evita 4, Hamilton Galileo, Nellcor-Puritan-Bennett 740 and 840, Siemens Servo 300A, and Bird Products Tbird AVS at 10 cm H(2)O continuous positive airway pressure. Lung model compliance was 50 ml/cm H(2)O with a resistance of 8.2 cm H(2)O x l(-1) x s(-1), and inspiratory time was set at 1.0 s with peak inspiratory flows of 40, 60, and 80 l/min. In ventilators with both pressure and flow triggering, the response of each was evaluated. Results With all ventilators, peak inspiratory flow, lung model tidal volume, and range of pressure change (below baseline to above baseline) increased as peak flow increased. Inspiratory trigger delay time, inspiratory cycle delay time, expiratory pressure time product, and total area of pressure change were not affected by peak flow, whereas pressure change to trigger inspiration, inspiratory pressure time product, and trigger pressure time product were affected by peak flow on some ventilators. There were significant differences among ventilators on all variables evaluated, but there was little difference between pressure and flow triggering in most variables on individual ventilators except for pressure to trigger. Pressure to trigger was 3.74 +/- 1.89 cm H(2)O (mean +/- SD) in flow triggering and 4.48 +/- 1.67 cm H(2)O in pressure triggering (P < 0.01) across all ventilators. Conclusions Most ventilators evaluated only imposed a small effort to trigger, but most also provided low-level pressure support and imposed an expiratory workload. Pressure triggering during continuous positive airway pressure does require a slightly greater pressure than flow triggering.

Simple point of care continuous positive airway pressure delivery device (Jain-CPAP)

2019 ◽  
Vol 5 (1) ◽  
pp. 13-19
Author(s):  
Ashish Jain ◽  
Robert M DiBlasi ◽  
Veena Devgan ◽  
Nisha Kumari ◽  
Kunal Kalra
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Preterm Neonate ◽  
Positive Airway Pressure ◽  
Point Of Care ◽  
Healthcare Providers ◽  
Linear Increase ◽  
Lung Model ◽  
Lung Mechanics ◽  
Mean Pressure

ObjectiveTo describe the effective pressure and FiO2 delivery to a realistic spontaneously breathing lung model using a novel, simple, inexpensive neonatal non-invasive bubble continuous positive airway pressure (CPAP) device.MethodsThis experimental bench study was conducted at Bench Testing Laboratory at a Children’s Hospital. A realistic 3D anatomic airway model of a 28-week preterm neonate was affixed to the ASL5000 Test Lung to simulate spontaneous breathing with lung mechanics that are specific to a preterm neonate. The assembly was constructed on site using easily available nasal prongs, paediatric infusion set with a graduated chamber, three-way stop cocks and oxygen tubing. The adult nasal prong was used as cannulae. However, this assembly had the limitation of the lack of humidification and inability to deliver graduated oxygen. This assembly was attached to the anatomic airway with nasal prongs. Pressure and FiO2 were measured from within the lung model at different flow settings and recorded for 10 breaths.ResultsThere was a linear increase in the mean pressure in the 10 recorded breaths as oxygen flows were increased.ConclusionsOur nasal CPAP is a simple device, as it can be easily assembled at the point of care using simple, affordable supplies by the healthcare providers and can benefit the newborns with respiratory distress in the resource constraint settings.

Effect on work of breathing of different continuous positive airway pressure devices evaluated in a premature neonatal lung model

2011 ◽  
Vol 12 (6) ◽  
pp. e376-e382 ◽  
Author(s):  
Werner Nikischin ◽  
Marianthi Petridis ◽  
Julia Noeske ◽  
Dietmar Spengler ◽  
Philipp von Bismarck
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Work Of Breathing ◽  
Lung Model ◽  
Neonatal Lung

scholarly journals Real-time multislice MRI during continuous positive airway pressure reveals upper airway response to pressure change

2017 ◽  
Vol 46 (5) ◽  
pp. 1400-1408 ◽  
Author(s):  
Weiyi Chen ◽  
Emily Gillett ◽  
Michael C.K. Khoo ◽  
Sally L. Davidson Ward ◽  
Krishna S. Nayak
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Real Time ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Upper Airway ◽  
Pressure Change ◽  
Airway Response

scholarly journals Bubble CPAP splitting: innovative strategy in resource-limited settings

2020 ◽  
pp. archdischild-2020-320030
Author(s):  
Akanksha Verma ◽  
Rahul Jaiswal ◽  
Kirti M Naranje ◽  
Girish Gupta ◽  
Anita Singh
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Simulation Model ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Lung Model ◽  
Respiratory Support ◽  
Resource Limited Settings ◽  
Non Invasive ◽  
Resource Limited ◽  
Different Levels

BackgroundNon-invasive respiratory support for neonates using bubble continuous positive airway pressure (bCPAP) delivery systems is now widespread owing to its safety, cost effectiveness and easy applicability. Many innovative solutions have been suggested to deal with the possible shortage in desperate situations like disasters, pandemics and resource-limited settings. Although splitting of invasive ventilation has been reported previously, no attempts to split non-invasive respiratory support have been reported.ObjectiveThe primary objective was to test the feasibility of splitting the bCPAP assembly using a T-piece splitter in a simulation model.MethodsA pilot simulation-based study was done to split a single bCPAP assembly using a T-piece. Other materials consisted of a heated humidification system, an air oxygen blender, corrugated inspiratory and expiratory tubing, nasal interfaces and two intercostal chest tube drainage bags. Two pressure manometers were used simultaneously to measure delivered pressures at different levels of set bCPAPs at the expiratory limb of nasal interfaces.ResultsPressures measured at the expiratory end of two nasal interfaces were 5.1 and 5.2 cm H2O, respectively, at a flow of 6 L/min and a water level of 5 cm H2O in both chest bags. When tested across different levels of set continuous positive airway pressure (3–8 cmH2O) and fractional inspired oxygen concentration (0.30–1.0), measured parameters corresponded to set parameters.ConclusionbCPAP splitting using a T-piece splitter is a technically simple, feasible and reliable strategy tested in a simulation model. Further testing is needed in a simulated lung model.

Effect of Pressure Oscillations on Neonatal Breathing

2004 ◽  
Author(s):  
P. I. Manilal ◽  
A. M. Al-Jumaily ◽  
N. Prime
Keyword(s):  
Mathematical Model ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Mechanical Response ◽  
Positive Airway Pressure ◽  
Lung Model ◽  
Pressure Oscillations ◽  
Bubble Cpap ◽  
Cpap Devices

Various methods of ventilation and continuous positive airway pressure (CPAP) devices have emerged to treat neonates suffering from respiratory distress syndrome (RDS). Among them is the Bubble CPAP device whose key distinguishing feature is the production of pressure oscillations, the presence of which has been suggested to offer added benefits to neonatal breathing. The mechanisms that cause these benefits, however, are not fully understood and many theories exist as to why pressure oscillations enhance the ventilation process. Using Simulink within Matlab environment, a mathematical model is developed to simulate the generation of pressure oscillations in the Bubble CPAP system and to investigate the mechanical response of the lung due to the pressure oscillations. Although the lung model incorporated in this investigation is simple, it gives a good trend of the lung behaviours under various pressure frequencies and amplitudes.

Continuous Positive Airway Pressure (CPAP) Therapy for the Treatment of Hypernasality: A Single Case Study

2014 ◽  
Vol 24 (2) ◽  
pp. 48-58 ◽  
Author(s):  
Lakshmi Kollara ◽  
Graham Schenck ◽  
Jamie Perry
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Single Case ◽  
Treatment Method ◽  
Post Treatment ◽  
Subjective Perception ◽  
Cpap Therapy ◽  
Long Term Follow Up

Studies have investigated the applications of Continuous Positive Airway Pressure (CPAP) therapy in the treatment of hypernasality due to velopharyngeal dysfunction (VPD; Cahill et al., 2004; Kuehn, 1991; Kuehn, Moon, & Folkins, 1993; Kuehn et al., 2002). The purpose of this study was to examine the effectiveness of CPAP therapy to reduce hypernasality in a female subject, post-traumatic brain injury (TBI) and pharyngeal flap, who presented with signs of VPD including persistent hypernasality. Improvements in mean velopharyngeal orifice size, subjective perception of hypernasality, and overall intelligibility were observed from the baseline to 8-week post-treatment assessment intervals. Additional long-term assessments completed at 2, 3, and 4 months post-treatment indicated decreases in immediate post-treatment improvements. Results from the present study suggest that CPAP is a safe, non-invasive, and relatively conservative treatment method for reduction of hypernasality in selected patients with TBI. More stringent long-term follow up may indicate the need for repeated CPAP treatment to maintain results.

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