Continuous Positive Airway Pressure Does Not Modifiy Cardio-Respiratory Events And Breathing-Swallowing Coordination During Oral Feeding In Lambs

2012 ◽  
Author(s):  
Anne Bernier ◽  
Amine Hadj Ahmed ◽  
Nathalie Samson ◽  
Céline Catelin ◽  
Jean-Paul Praud
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Oral Feeding ◽  
Respiratory Events

scholarly journals Effects of nasal continuous positive-airway pressure on nutritive swallowing in lambs

2012 ◽  
Vol 112 (12) ◽  
pp. 1984-1991 ◽  
Author(s):  
Anne Bernier ◽  
Céline Catelin ◽  
Mohamed Amine Hadj Ahmed ◽  
Nathalie Samson ◽  
Pauline Bonneau ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Current Knowledge ◽  
Ventilatory Support ◽  
Bottle Feeding ◽  
Oral Feeding ◽  
Great Success ◽  
Arterial Blood ◽  
Laryngeal Penetration

Current knowledge suggests that, to be successful, oral feeding in preterm infants should be initiated as soon as possible, often at an age where immature respiration still requires ventilatory support in the form of nasal continuous positive airway pressure (nCPAP). While some neonatologist teams claim great success with initiation of oral feeding in immature infants with nCPAP, others strictly wait for this ventilatory support to be no longer necessary before any attempt at oral feeding, fearing laryngeal penetration and tracheal aspiration. Therefore, the aim of the present study was to provide a first assessment of the effect of various levels of nCPAP on bottle-feeding in a neonatal ovine model, including feeding safety, feeding efficiency, and nutritive swallowing-breathing coordination. Eight lambs born at term were surgically instrumented 48 h after birth to collect recordings of electrical activity of laryngeal constrictor muscle, electrocardiography, and arterial blood gases. Two days after surgery, lambs were bottle-fed under five randomized nCPAP conditions, including without any nCPAP or nasal mask and nCPAP of 0, 4, 7, and 10 cmH2O. Results revealed that application of nCPAP in the full-term lamb had no deleterious effect on feeding safety and efficiency or on nutritive swallowing-breathing coordination. The present study provides a first and unique insight on the effect of nCPAP on oral feeding, demonstrating its safety in newborn lambs born at term. These results open the way for further research in preterm lambs to better mimic the problems encountered in neonatology.

scholarly journals The effects of oral feeding while on nasal continuous positive airway pressure (NCPAP) in preterm infants

2020 ◽  
Vol 40 (6) ◽  
pp. 909-915 ◽  
Author(s):  
Vikramaditya Dumpa ◽  
Ranjith Kamity ◽  
Louisa Ferrara ◽  
Meredith Akerman ◽  
Nazeeh Hanna
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Preterm Infants ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Oral Feeding

Polygraphic respiratory events during sleep in children treated with home continuous positive airway pressure: description and clinical consequences

2015 ◽  
Vol 16 (1) ◽  
pp. 107-112 ◽  
Author(s):  
Alessandro Amaddeo ◽  
Valeria Caldarelli ◽  
Marta Fernandez-Bolanos ◽  
Johan Moreau ◽  
Adriana Ramirez ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Respiratory Events ◽  
Clinical Consequences

scholarly journals Algorithm for automatic detection of self-similarity and prediction of residual central respiratory events during continuous positive airway pressure

SLEEP ◽  
2020 ◽  
Author(s):  
Eline Oppersma ◽  
Wolfgang Ganglberger ◽  
Haoqi Sun ◽  
Robert J Thomas ◽  
M Brandon Westover
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Significant Risk ◽  
Periodic Breathing ◽  
Driving Mechanism ◽  
Central Apnea ◽  
Self Similarity ◽  
Respiratory Events ◽  
High Loop

Abstract Study Objectives Sleep-disordered breathing is a significant risk factor for cardiometabolic and neurodegenerative diseases. High loop gain (HLG) is a driving mechanism of central sleep apnea or periodic breathing. This study presents a computational approach that identifies “expressed/manifest” HLG via a cyclical self-similarity feature in effort-based respiration signals. Methods Working under the assumption that HLG increases the risk of residual central respiratory events during continuous positive airway pressure (CPAP), the full night similarity, computed during diagnostic non-CPAP polysomnography (PSG), was used to predict residual central events during CPAP (REC), which we defined as central apnea index (CAI) higher than 10. Central apnea labels are obtained both from manual scoring by sleep technologists and from an automated algorithm developed for this study. The Massachusetts General Hospital sleep database was used, including 2466 PSG pairs of diagnostic and CPAP titration PSG recordings. Results Diagnostic CAI based on technologist labels predicted REC with an area under the curve (AUC) of 0.82 ± 0.03. Based on automatically generated labels, the combination of full night similarity and automatically generated CAI resulted in an AUC of 0.85 ± 0.02. A subanalysis was performed on a population with technologist-labeled diagnostic CAI higher than 5. Full night similarity predicted REC with an AUC of 0.57 ± 0.07 for manual and 0.65 ± 0.06 for automated labels. Conclusions The proposed self-similarity feature, as a surrogate estimate of expressed respiratory HLG and computed from easily accessible effort signals, can detect periodic breathing regardless of admixed obstructive features such as flow limitation and can aid the prediction of REC.

scholarly journals Oral feeding for infants and children receiving nasal continuous positive airway pressure and high flow nasal cannula: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Angie Canning ◽  
Sally Clarke ◽  
Sarah Thorning ◽  
Manbir Chauhan ◽  
Kelly A Weir
Keyword(s):  
Systematic Review ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Clinical Signs ◽  
High Flow ◽  
Oral Feeding ◽  
Infants And Children ◽  
High Flow Nasal Cannula ◽  
Oropharyngeal Aspiration

Abstract Background The aim of this systematic review was to determine whether introduction of oral feeding for infants and children receiving nasal continuous positive airway pressure (nCPAP) or high flow nasal cannula (HFNC) respiratory support facilitates achievement of full oral feeding without adverse effects, compared to no oral feeding (NPO; nil per oral) on CPAP or HFNC. Methods A protocol was lodged with the PROSPERO International Prospective Register of Systematic Reviews. We searched Medline, Embase, CINAHL, CENTRAL and AustHealth from database inception to 10th June 2020. Study population included children (preterm to < 18 years) on nCPAP or HFNC who were orally feeding. Primary outcomes included full or partial oral feeding and oropharyngeal aspiration. Secondary outcomes examined adverse events including clinical signs of aspiration, aspiration pneumonia and deterioration in respiratory status. Results The search retrieved 1684 studies following duplicate removal. Title and abstract screening identified 70 studies for full text screening and of these, 16 were included in the review for data extraction. Methods of non-invasive ventilation (NIV) included nCPAP (n = 6), nCPAP and HFNC (n = 5) and HFNC (n = 5). A metanalysis was not possible as respiratory modes and cohorts were not comparable. Eleven studies reported on adverse events. Oral feeding safety was predominantly based on retrospective data from chart entries and clinical signs, with only one study using an instrumental swallow evaluation (VFSS) to determine aspiration status. Conclusions Findings are insufficient to conclude whether commencing oral feeding whilst on nCPAP or HFNC facilitates transition to full oral feeding without adverse effects, including oropharyngeal aspiration. Further research is required to determine the safety and efficacy of oral feeding on CPAP and HFNC for infants and children. Trial registration PROSPERO registration number: CRD42016039325.

Sign in / Sign up

Export Citation Format

Share Document