Noise levels during nCPAP are flow-dependent but not device-dependent

Karam, Oliver; Donatiello, C; Lancker, Eric Van; Chritin, V.; Pfister, Riccardo; Rimensberger, Peter C.

doi:10.1136/adc.2007.129098

Cited by 33 publications

(29 citation statements)

References 14 publications

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“…The recorded noise in our experiment represents the sum of sounds arising from this leakage as well as from gas flow and turbulences within the ventilator tubes. The correlation between gas flow and noise in this experimental setup was similar to that described in vivo by Karam et al [7] and Surenthiran et al [25] . Another aspect that has to be considered is the fact that in vivo bone conduction decreases the amount of noise transmitted to the inner ear.…”

Section: Discussionsupporting

confidence: 68%

“…Among the main sources of noise in neonatal wards are the continuous positive airway pressure (CPAP) generators. A recent study by Karam et al [7] showed mean noise intensities of up to 120 decibels in an Aweighted scale [dB(A)] measured in the oral cavity of neonates on CPAP support. However, in this study, only jet CPAP generators were investigated.…”

Section: Introductionmentioning

confidence: 99%

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In vitro Comparison of Noise Levels Produced by Different CPAP Generators

Kirchner

Wald²,

Jeitler³

et al. 2011

Neonatology

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Introduction: Minimization of noise exposure is an important aim of modern neonatal intensive care medicine. Binasal continuous positive airway pressure (CPAP) generators are among the most important sources of continuous noise in neonatal wards. The aim of this study was to find out which CPAP generator creates the least noise. Method: In an experimental setup, two jet CPAP generators (Infant Flow® generator and MediJet®) and two conventional CPAP generators (Bubble CPAP® and Baby Flow®) were compared. Noise production was measured in decibels in an A-weighted scale [dB(A)] in a closed incubator at 2 mm lateral distance from the end of the nasal prongs. Reproduction of constant airway pressure and air leak was achieved by closure of the nasal prongs with a type of adhesive tape that is semipermeable to air. Results: The noise levels produced by the four generators were significantly different (p < 0.001). Values measured at a continuous constant flow rate of 8 l/min averaged 83 dB(A) for the Infant Flow® generator with or without sound absorber, 72 dB(A) for the MediJet®, 62 dB(A) for the Bubble CPAP® and 55 dB(A) for the Baby Flow®. Conclusion: Conventional CPAP generators work more quietly than the currently available jet CPAP generators.

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Section: Discussionsupporting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

In vitro Comparison of Noise Levels Produced by Different CPAP Generators

Kirchner

Wald²,

Jeitler³

et al. 2011

Neonatology

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“…Due to the growing concern of excessive noise exposure in the NICU, noise levels generated by CPAP devices have been assessed in a number of studies previously [8,9,10]. This study is, to the best of our knowledge, the first to assess noise levels of HFNC devices.…”

Section: Discussionmentioning

confidence: 98%

“…Their study revealed that noise levels are much higher in the post-nasal space, in particular in babies on CPAP. A recent study by Karam et al [9] investigated noise levels of several CPAP devices by measuring in the oral cavity of preterm infants. The mean noise level was 88.6 dB(A) in their study, with two thirds of the measurements exceeding 90 dB(A).…”

Section: Discussionmentioning

confidence: 99%

“…Continuous positive airway pressure (CPAP) has become the preferred mode of respiratory support in this population, however CPAP devices generate noise levels significantly above current recommendations [1,8,9,10]. In recent years, the use of high-flow nasal cannula (HFNC) devices gained increased popularity in NICUs as an alternative non-invasive ventilation (NIV) modality post-extubation, as primary treatment of apnea of prematurity and respiratory distress syndrome, or to wean neonates from CPAP, despite a lack of supporting data from large prospective trials [11,12].…”

Section: Introductionmentioning

confidence: 99%

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Noise Levels of Neonatal High-Flow Nasal Cannula Devices - An in-vitro Study

König¹,

Stock²,

Jarvis³

2013

Neonatology

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Background: Excessive ambient noise levels have been identified as a potential risk factor for adverse outcome in very preterm infants. Noise level measurements for continuous positive airway pressure (CPAP) devices demonstrated that these constantly exceed current recommendations. The use of high-flow nasal cannula (HFNC) as an alternative non-invasive ventilation modality has become more popular in recent years in neonatal care. Objective: To study noise levels of two HFNC devices commonly used in newborns. As a comparison, noise levels of a continuous flow CPAP device were also studied. Methods: In-vitro study. The noise levels of two contemporary HFNC devices (Fisher & Paykel NHF™ and Vapotherm Precision Flow®) and one CPAP device (Dräger Babylog® 8000 plus) were measured in the oral cavity of a newborn manikin in an incubator in a quiet environment. HFNC flows of 4-8 l/min and CPAP pressures of 4-8 cm H₂O were applied. The CPAP flow was set at 8 l/min as per unit practice. Results: Vapotherm HFNC generated the highest noise levels, measuring 81.2-91.4 dB(A) with increasing flow. Fisher & Paykel HFNC noise levels were between 78.8 and 81.2 dB(A). The CPAP device generated the lowest noise levels between 73.9 and 77.4 dB(A). Conclusions: Both HFNC devices generated higher noise levels than the CPAP device. All noise levels were far above current recommendations of the American Academy of Pediatrics. In light of the long duration of non-invasive respiratory support of very preterm infants, less noisy devices are required to prevent the potentially adverse effects of continuing excessive noise exposure in the neonatal intensive care unit.

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Noninvasive Respiratory Support in the Neonate

Kugelman

2014

Pediatric and Neonatal Mechanical Ventilation

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Noise levels during nCPAP are flow-dependent but not device-dependent

Cited by 33 publications

References 14 publications

In vitro Comparison of Noise Levels Produced by Different CPAP Generators

In vitro Comparison of Noise Levels Produced by Different CPAP Generators

Noise Levels of Neonatal High-Flow Nasal Cannula Devices - An in-vitro Study

Noninvasive Respiratory Support in the Neonate

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