Original ArticleEffect of Nasal Continuous and Biphasic Positive Airway Pressure on Lung Volume in Preterm Infants
Section snippets
Methods
The study was performed in the neonatal intensive care unit of the Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands. The study was approved by the central committee on research involving human subjects, and written informed consent was obtained from both parents. Infants born at less than 32 weeks of gestation and who were younger than 7 days of age were eligible for enrollment if they were treated with nCPAP and were clinically stable (fraction of inspired oxygen
Results
Twenty-two preterm infants were included and finished the study protocol without experiencing any complications (Table I). Despite extensive efforts, we were not able to establish consistent synchronization via the Graseby capsule during the BiPAP mode in the third phase of the study. The limited number of triggered breaths prevented meaningful analyses; thus, only the data from the phases 1 and 2 are reported.
Discussion
We investigated the effect of different nCPAP levels and BiPAP on the regional changes in EELV and ventilation measured with electrical impedance tomography. Our main findings are that increasing nCPAP levels result in a homogeneous increase in EELV and a more dorsal, physiologic distribution of ventilation. Unsynchronized BiPAP also increased EELV but did not affect the tidal volume and its distribution.
We simultaneously measured lung volume changes with respiratory induction plethysmography
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2019, Clinics in PerinatologyCitation Excerpt :This device can be adapted to simulate the PIP seen with conventional NIPPV.53,62 The Graseby capsule has also been incorporated into the SiPAP device to produce synchronized bilevel CPAP.53 Nasal mask or prongs, which may be short or long, single or binasal, are interfaces commonly used with NIPPV and bilevel CPAP.
Nasal intermittent positive pressure ventilation in preterm infants: Equipment, evidence, and synchronization
2016, Seminars in Fetal and Neonatal MedicineCitation Excerpt :In the UK [45], 77% of nurseries using NIPPV reported attempting synchronization using the GC and SiPAP, whereas in Brazil 1% used this method, 45% used ventilator pressure triggers, and the remainder did not attempt synchronization [47]. Researchers are not always successful in using synchronization; Mediema et al. [23] reported that in 22 infants where synchronization was attempted using the GC and SiPAP, so few breaths were correctly triggered that analysis was not possible. Courtney reported that attempts at synchronization using flow triggering were also unsuccessful [42].
The electrical impedance tomography device was provided by CareFusion. The authors declare no conflicts of interest.