Pharyngeal pressure value using two continuous positive airway pressure devices

Colnaghi, Mariarosa; Matassa, Piero Giuseppe; Fumagalli, Monica; Messina, D; Mosca, Fabio

doi:10.1136/adc.2007.120428

Cited by 11 publications

(4 citation statements)

References 9 publications

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“…Modern CPAP circuits are designed to have no contribution to resistance, and many include a distal pressure monitoring port to ensure target circuit pressure is maintained. However, factors beyond the circuit may contribute to pressure loss, including leak at the nose or mouth, or resistance of the interface 8 9. Given there is a direct relationship between pressure, resistance and flow, the pressure produced by the system can therefore be used as an indication of the system’s intrinsic resistance, or more specifically, that of the nasal interface 10 11.…”

Section: Introductionmentioning

confidence: 99%

Assessment of resistance of nasal continuous positive airway pressure interfaces

Green

Dawson²,

Davis

et al. 2018

Arch Dis Child Fetal Neonatal Ed

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ObjectiveTo compare the resistance of interfaces used for the delivery of nasal continuous positive airway pressure (CPAP) in neonates, as measured by the generated system pressure at fixed gas flows, in an in vitro setting.DesignGas flows of 6, 8 and 10 L/min were passed through three sizes of each of a selection of available neonatal nasal CPAP interfaces (Hudson prong, RAM Cannula, Fisher & Paykel prong, Infant Flow prong, Fisher & Paykel mask, Infant Flow mask). The expiratory limb was occluded and pressure differential measured using a calibrated pressure transducer.ResultsVariation in resistance, assessed by mean pressure differential, was seen between CPAP interfaces. Binasal prong interfaces typically had greater resistance at the smallest assessed sizes, and with higher gas flows. However, Infant Flow prongs produced low pressures (<1.5 cmH2O) at all sizes and gas flows. RAM Cannula had a high resistance, producing a pressure >4.5 cmH2O at all sizes and gas flows. Both nasal mask interfaces had low resistance at all assessed sizes and gas flows, with recorded pressure <1 cmH2O in all cases.ConclusionsThere is considerable variation in measured resistance of available CPAP interfaces at gas flows commonly applied in clinical neonatal care. Use of interfaces with high resistance may result in a greater drop in delivered airway pressure in comparison to set circuit pressure, which may have implications for clinical efficacy. Device manufacturers and clinicians should consider CPAP interface resistance prior to introduction into routine clinical care.

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Section: Introductionmentioning

confidence: 99%

Assessment of resistance of nasal continuous positive airway pressure interfaces

Green

Dawson²,

Davis

et al. 2018

Arch Dis Child Fetal Neonatal Ed

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show abstract

“…As recently as 2008 an Italian team published a small trial using a hood-and-neck seal instead of 'nasal prongs' to deliver continuous positive airway pressure. 21 This showed that pharyngeal pressure was more stable when a hood-and-neck seal device was used. The only difference between the approach that we had started to use in 1989 and the approach now being studied in Italy is that we used negative pressure round the chest and they are now using positive pressure round the head.…”

Section: The Wider Damage To Researchmentioning

confidence: 97%

“…Calls for further research and development continue to be made, 20 but clinicians in Stoke are still barred from using CNEP even in older children despite the interest in this type of treatment that persists elsewhere. As recently as 2008 an Italian team published a small trial using a hood-and-neck seal instead of ‘nasal prongs’ to deliver continuous positive airway pressure 21 . This showed that pharyngeal pressure was more stable when a hood-and-neck seal device was used.…”

Section: The Wider Damage To Researchmentioning

confidence: 99%

The Stoke CNEP Saga – how it damaged all involved

Wright¹

2010

J R Soc Med

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“…It is estimated that an inspired flow of 5 cm H 2 O results in nasal pharyngeal distending pressure of approximately 2-3 cm H 2 O. 4 Many factors, such as air leak, mouth opening and a diameter of IFT, can affect the delivered pressure. An in-depth knowledge of the possible complications are mandatory before using this model.…”

mentioning

confidence: 99%