Basic principles of neonatal bubble CPAP: effects on CPAP delivery and imposed work of breathing when altering the original design. Issue 5 (11th February 2020)
- Record Type:
- Journal Article
- Title:
- Basic principles of neonatal bubble CPAP: effects on CPAP delivery and imposed work of breathing when altering the original design. Issue 5 (11th February 2020)
- Main Title:
- Basic principles of neonatal bubble CPAP: effects on CPAP delivery and imposed work of breathing when altering the original design
- Authors:
- Baldursdottir, Sonja
Falk, Markus
Donaldsson, Snorri
Jonsson, Baldvin
Drevhammar, Thomas - Abstract:
- Abstract : Background: The original bubble continuous positive airway pressure (bCPAP) design has wide-bore tubing and a low-resistance interface. This creates a stable airway pressure that is reflected by the submersion depth of the expiratory tubing. Several systems with alterations to the original bCPAP design are now available. Most of these are aimed for use in low-income and middle-income countries and have not been compared with the original design. Objective: We identified three major alterations to the original bCPAP design: (1) resistance of nasal interface, (2) volume of dead space and (3) diameter of expiratory tubing. Our aim was to study the effect of these alterations on CPAP delivery and work of breathing in a mechanical lung model. Dead space should always be avoided and was not further tested. Methods: The effect of nasal interface resistance and expiratory tubing diameter was evaluated with simulated breathing in a mechanical lung model without interface leakage. The main outcome was delivered CPAP and imposed work of breathing. Results: High-resistance interfaces and narrow expiratory tubing increased the work of breathing. Additionally, narrow expiratory tubing resulted in higher CPAP levels than indicated by the submersion depth. Conclusion: Our study shows the significant effect on CPAP delivery and imposed work of breathing when using high-resistance interfaces and narrow expiratory tubing in bCPAP systems. New systems should include low-resistanceAbstract : Background: The original bubble continuous positive airway pressure (bCPAP) design has wide-bore tubing and a low-resistance interface. This creates a stable airway pressure that is reflected by the submersion depth of the expiratory tubing. Several systems with alterations to the original bCPAP design are now available. Most of these are aimed for use in low-income and middle-income countries and have not been compared with the original design. Objective: We identified three major alterations to the original bCPAP design: (1) resistance of nasal interface, (2) volume of dead space and (3) diameter of expiratory tubing. Our aim was to study the effect of these alterations on CPAP delivery and work of breathing in a mechanical lung model. Dead space should always be avoided and was not further tested. Methods: The effect of nasal interface resistance and expiratory tubing diameter was evaluated with simulated breathing in a mechanical lung model without interface leakage. The main outcome was delivered CPAP and imposed work of breathing. Results: High-resistance interfaces and narrow expiratory tubing increased the work of breathing. Additionally, narrow expiratory tubing resulted in higher CPAP levels than indicated by the submersion depth. Conclusion: Our study shows the significant effect on CPAP delivery and imposed work of breathing when using high-resistance interfaces and narrow expiratory tubing in bCPAP systems. New systems should include low-resistance interfaces and wide-bore tubing and be compared with the original bCPAP. Referring to all systems that bubble as bCPAP is misleading and potentially hazardous. … (more)
- Is Part Of:
- Archives of disease in childhood. Volume 105:Issue 5(2020)
- Journal:
- Archives of disease in childhood
- Issue:
- Volume 105:Issue 5(2020)
- Issue Display:
- Volume 105, Issue 5 (2020)
- Year:
- 2020
- Volume:
- 105
- Issue:
- 5
- Issue Sort Value:
- 2020-0105-0005-0000
- Page Start:
- 550
- Page End:
- 554
- Publication Date:
- 2020-02-11
- Subjects:
- intensive care -- neonatology -- respiratory
Infants -- Diseases -- Periodicals
Newborn infants -- Diseases -- Periodicals
Fetus -- Diseases -- Periodicals
618.920105 - Journal URLs:
- http://fn.bmjjournals.com ↗
http://www.bmj.com/archive ↗ - DOI:
- 10.1136/archdischild-2019-318073 ↗
- Languages:
- English
- ISSNs:
- 1359-2998
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - BLDSS-3PM
British Library STI - ELD Digital store - Ingest File:
- 17706.xml