Effect of continuous positive airway pressure on lung mechanics during high-frequency jet ventilation

Viele Frühgeborene mit einem Atemnotsyndrom (engl. Respiratory Distress Syndrome, RDS) erhalten zunächst eine nicht invasive Atemunterstützung. Ein chinesisches Forscherteam untersuchte nun, welche Methode besser vor einem invasiven mechanischen Beatmungsbedarf schützte: Der nasale CPAP (Continuous Positive Airway Pressure) oder die nasale HFOV (High-Frequency Oscillatory Ventilation).

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

BMJ Innovations ◽

10.1136/bmjinnov-2018-000339 ◽

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.

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Respiratory therapy techniques

10.1093/med/9780199229581.003.0001 ◽

2011 ◽

Author(s):

Carl Waldmann ◽

Neil Soni ◽

Andrew Rhodes

Keyword(s):

Continuous Positive Airway Pressure ◽

Prone Position ◽

High Frequency ◽

Airway Pressure ◽

Oxygen Therapy ◽

Positive Airway Pressure ◽

Ventilatory Support ◽

High Frequency Ventilation ◽

Frequency Ventilation ◽

Positive Airway Pressure Ventilation

Oxygen therapy 2Ventilatory support: indications 6IPPV—description of ventilators 8IPPV—modes of ventilation 10IPPV—adjusting the ventilator 12IPPV—barotrauma 14IPPV—weaning techniques 16High-frequency ventilation 18Positive end-respiratory pressure 22Continuous positive airway pressure ventilation (CPAP) 24Recruitment manoeuvres 26Prone position ventilation 28...

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Comparison of Endotracheal Reintubation between Nasal High-Frequency Oscillation and Continuous Positive Airway Pressure in Neonates

American Journal of Perinatology ◽

10.1055/s-0039-1679932 ◽

2019 ◽

Vol 37 (04) ◽

pp. 409-414

Author(s):

Anucha Thatrimontrichai ◽

Kantisa Sirianansopa ◽

Waricha Janjindamai ◽

Supaporn Dissaneevate ◽

Gunlawadee Maneenil

Keyword(s):

Continuous Positive Airway Pressure ◽

High Frequency ◽

Airway Pressure ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Positive Airway Pressure ◽

Face Mask ◽

High Frequency Oscillation ◽

Hazards Model ◽

Significant Difference

Objective This study aimed to compare the endotracheal reintubation between nasal high-frequency oscillation (nHFO) and nasal continuous positive airway pressure (nCPAP) with face mask groups who were followed up for up to 7 days. Study Design We performed a retrospective cohort study of extubated neonates admitted between 2013 and 2017. We used a Cox's proportional hazards model to adjust for significant between-group differences in baseline characteristics. Results One hundred and ninety-nine neonates were on either nHFO or nCPAP after extubation. The median (interquartile range) gestational age and birth weight were 31 (29, 33) weeks and 1,450 (1,065, 1,908) grams, respectively. From the univariate analysis, gestational age, ventilator modes, mean airway pressure, fraction of inspired oxygen, oxygen index, caffeine therapy, and initial continuous positive airway pressure level were significantly different between the nHFO and nCPAP groups. There was no significant difference in the 7-day reintubation rate of neonates on nHFO compared with nCPAP (hazard ratio: 2.39; 95% confidence interval: 0.97–5.84; p = 0.05). By multivariate analysis, there was no statistically significant difference of reintubation rate between nHFO and nCPAP by Cox's proportional hazards model. Conclusion The nHFO mode with face mask is the choice for noninvasive ventilation to prevent reintubation during the week following extubation.

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