Bubble CPAP: Not All Bubbling Is Good Bubbling

Mastropietro, Christopher W.

doi:10.4187/respcare.02872

Cited by 2 publications

(1 citation statement)

References 8 publications

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“…NHF augments the swings in airway pressure during breathing, probably by generating resistance to expiratory flow and reducing the resistance to inspiratory flow (23). In the present study bCPAP also increased the swings in airway pressure, which has been observed previously (18,37). During bCPAP, the increased dynamic range of pressures may be caused by the high impedance in the breathing circuit.…”

Section: Discussionsupporting

confidence: 80%

Mechanisms of nasal high flow therapy in newborns

Mazmanyan

Darakchyan

Pinkham

et al. 2020

Journal of Applied Physiology

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In newborns, it is unclear how nasal high flow (NHF) generates positive airway pressure. In addition, the reported benefits of NHF such as reduction in work of breathing may be independent of airway pressure. The authors hypothesized that during NHF the area of leak and the flow determine airway pressure and that NHF can reduce the required minute ventilation to maintain gas exchange. In response to NHF, pressure was measured in the upper airways of 9 newborns and ventilation was measured in another group of 17 newborns. In a bench model, airway pressures were measured during NHF with different prong sizes, nare sizes, and flows. The airway pressures during 8 L/min NHF were greater when a larger cannula versus a smaller cannula was used ( P < 0.05). NHF reduced minute ventilation in 16 of 17 neonates, with a mean decrease of 24% from a baseline of 0.66 L/min (SD 0.21) ( P < 0.001), and was unrelated to changes in airway pressure; arterial oxygen saturation by pulse oximetry ([Formula: see text]) and tissue CO2 were unchanged. In the bench model, the airway pressure remained <2 cmH2O when <50% of the “nare” was occluded by the prongs. As the leak area decreased, because of a smaller nare or a larger cannula, the airway pressure increased exponentially and was dependent on flow. In newborns NHF using room air substantially reduced minute ventilation without affecting gas exchange irrespective of a decrease or an increase of respiratory rate. NHF generates low positive airway pressure that exponentially increases with flow and occlusion of the nares. NEW & NOTEWORTHY In healthy newborns, nasal high flow (NHF) with room air reduced minute ventilation by one-fourth without affecting gas exchange but, in contrast to adults, produced variable response in respiratory rate during sleep. During NHF, pressure in the upper airways did not exceed 2 cmH2O at 8 L/min (3.4 L·min−1·kg−1) and was unaffected by opening of the mouth. NHF can generate higher pressure with larger prongs that decrease the leak around the cannula or by increasing the flow rate.

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Section: Discussionsupporting

confidence: 80%

Mechanisms of nasal high flow therapy in newborns

Mazmanyan

Darakchyan

Pinkham

et al. 2020

Journal of Applied Physiology

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Comparative Effectiveness of Bubble versus Ventilator-Derived Nasal Continuous Positive Airway Pressure on the Management of Transient Tachypnoea of the Newborn: A Retrospective Cohort Study in a Tertiary Care Hospital

TUTAK,

ÇELİK

2024

Preprint

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Background Transient Tachypnoea of the Newborn (TTN) is a common cause of neonatal respiratory distress, often requiring respiratory support with Continuous Positive Airway Pressure (CPAP). This study compares the effectiveness of Bubble CPAP (BCPAP) and Ventilator-derived CPAP (VCPAP) in reducing NICU admissions in late preterm and term neonates with TTN. Materials and Methods This retrospective cohort study analysed 144 neonates born at or beyond 34 weeks' gestation with TTN who received either BCPAP (n = 70) or VCPAP (n = 74) in the delivery room. Outcomes included NICU admissions, length of hospital stay, intubation rates, surfactant use, and complications. Results There were no significant differences between the groups in NICU admissions (p > 0.05), hospital stay, intubation rates, or surfactant use. No cases of sepsis, necrotizing enterocolitis, or pneumothorax were observed. Conclusion Both BCPAP and VCPAP were equally effective in managing TTN, with no notable difference in clinical outcomes or safety. Further prospective studies are required to validate these findings.

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Bubble CPAP: Not All Bubbling Is Good Bubbling

Cited by 2 publications

References 8 publications

Mechanisms of nasal high flow therapy in newborns

Mechanisms of nasal high flow therapy in newborns

Comparative Effectiveness of Bubble versus Ventilator-Derived Nasal Continuous Positive Airway Pressure on the Management of Transient Tachypnoea of the Newborn: A Retrospective Cohort Study in a Tertiary Care Hospital

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