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.

A Viscoelastic Model of the Neonatal Respiratory System to Assess the Efficacy of CPAP Devices

2008 ◽  
Author(s):  
Prasika I. Reddy ◽  
Ahmed M. Al-Jumaily ◽  
Geoff T. Bold
Keyword(s):  
Mathematical Model ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
Viscoelastic Model ◽  
Engineering Practice ◽  
Neonatal Lung ◽  
Cpap Devices ◽  
Airway Model

The objectives of this research were to; develop a validated mathematical model of the premature neonatal lung. A description of the multi-compartmental, branched airway model of the neonatal lung is presented and shown to compare well with existing in-vivo data from the literature. The model described will be used in engineering practice to assess the design of conventional and emerging forms of continuous positive airway pressure (CPAP) devices in treating respiratory distress syndrome (RDS) in premature neonates.

Vibrations Generated by Pressure Oscillations for Improving Neonates Breathing

2003 ◽  
Author(s):  
A. M. Al-Jumaily ◽  
P. I. Manilal ◽  
N. Prime
Keyword(s):  
Structural Analysis ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Natural Frequencies ◽  
Positive Airway Pressure ◽  
Frequency Range ◽  
Pressure Oscillations ◽  
Exciting Frequency ◽  
The Relationship ◽  
Cpap Devices

In this paper a structural analysis approach is developed to explain the relationship between the exciting pressure signals generated by the bubble continuous positive airway pressure (CPAP) devices and the vibration generated in the respiratory walls. It is demonstrated that the natural frequencies of the central airways in infants fall within the exciting frequency range, which helps in relaxing the respiratory walls, and gives them a better chance of faster recovery.

scholarly journals Non-invasive duo positive airway pressure ventilation versus nasal continuous positive airway pressure in preterm infants with respiratory distress syndrome: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arash Malakian ◽  
Mohammad Reza Aramesh ◽  
Mina Agahin ◽  
Masoud Dehdashtian
Keyword(s):  
Mechanical Ventilation ◽  
Continuous Positive Airway Pressure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Abstract Background The most common cause of respiratory failure in premature infants is respiratory distress syndrome. Historically, respiratory distress syndrome has been treated by intratracheal surfactant injection followed by mechanical ventilation. In view of the risk of pulmonary injury associated with mechanical ventilation and subsequent chronic pulmonary lung disease, less invasive treatment modalities have been suggested to reduce pulmonary complications. Methods 148 neonates (with gestational age of 28 to 34 weeks) with respiratory distress syndrome admitted to Imam Khomeini Hospital in Ahwaz in 2018 were enrolled in this clinical trial study. 74 neonates were assigned to duo positive airway pressure (NDUOPAP) group and 74 neonates to nasal continuous positive airway pressure (NCPAP) group. The primary outcome in this study was failure of N-DUOPAP and NCPAP treatments within the first 72 h after birth and secondary outcomes included treatment complications. Results there was not significant difference between DUOPAP (4.1 %) and NCPAP (8.1 %) in treatment failure at the first 72 h of birth (p = 0.494), but non-invasive ventilation time was less in the DUOPAP group (p = 0.004). There were not significant differences in the frequency of patent ductus arteriosus (PDA), pneumothorax, intraventricular hemorrhage (IVH) and bronchopulmonary dysplasia (BPD), apnea and mortality between the two groups. Need for repeated doses of surfactant (p = 0.042) in the NDUOPAP group was significantly lower than that of the NCPAP group. The duration of oxygen therapy in the NDUOPAP group was significantly lower than that of the NCPAP group (p = 0.034). Also, the duration of hospitalization in the NDUOPAP group was shorter than that of the NCPAP group (p = 0.002). Conclusions In the present study, DUOPAP compared to NCPAP did not reduce the need for mechanical ventilation during the first 72 h of birth, but the duration of non-invasive ventilation and oxygen demand, the need for multiple doses of surfactant and length of stay in the DUOPAP group were less than those in the CPAP group. Trial registration IRCT20180821040847N1, Approved on 2018-09-10.

scholarly journals Bi-Level Noninvasive Ventilation in Neonatal Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis

Neonatology ◽  
2021 ◽  
Vol 118 (3) ◽  
pp. 264-273
Author(s):  
Anne Lee Solevåg ◽  
Po-Yin Cheung ◽  
Georg M. Schmölzer
Keyword(s):  
Systematic Review ◽  
Continuous Positive Airway Pressure ◽  
Respiratory Distress Syndrome ◽  
Premature Infants ◽  
Airway Pressure ◽  
Distress Syndrome ◽  
Positive Airway Pressure ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled

<b><i>Background:</i></b> Bi-level noninvasive ventilation (NIV) has been used in respiratory distress syndrome (RDS) as primary treatment, post-extubation, and to treat apnea. This review summarizes studies on bi-level NIV in premature infants with RDS. Nonsynchronized nasal intermittent positive pressure ventilation (nsNIPPV) and synchronized NIPPV (SNIPPV) use pressure settings ≥ those used during mechanical ventilation (MV), and biphasic continuous positive airway pressure (BiPAP) use two nasal continuous positive airway pressure (NCPAP) levels ≤4 cm H<sub>2</sub>O apart. <b><i>Methods:</i></b> A systematic review (Medline OVID and Pubmed) and meta-analysis of randomized controlled trials. Primary outcomes were bronchopulmonary dysplasia (BPD) and mortality. Secondary outcomes included NIV failure (intubation) and extubation failure (re-intubation). Data were pooled using a fixed-effects model to calculate the relative risk (RR) with 95% confidence interval (CI) between NIV modes (RevMan v 5.3, Copenhagen, Denmark). <b><i>Results:</i></b> Twenty-four randomized controlled trials that largely did not correct for mean airway pressure (MAP) and used outdated ventilators were included. Compared with NCPAP, both nsNIPPV and SNIPPV resulted in less re-intubation (RR 0.88 with 95% CI (0.80, 0.97) and RR 0.20 (0.10, 0.38), respectively) and BPD (RR 0.69 (0.49, 0.97) and RR 0.51 (0.29, 0.88), respectively). nsNIPPV also resulted in less intubation (RR 0.57 (0.45, 0.73) versus NCPAP, with no difference in mortality. One study showed less intubation in BiPAP versus NCPAP. <b><i>Conclusions:</i></b> Bi-level NIV versus NCPAP may reduce MV and BPD in premature infants with RDS. Studies comparing equivalent MAP utilizing currently available machines are needed.

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