Continuous Positive Airway Pressure Strategies with Bubble Nasal Continuous Positive Airway Pressure

Welty, Stephen E.

doi:10.1016/j.clp.2016.07.004

Cited by 16 publications

(26 citation statements)

References 23 publications

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“…Higher pressures improve oxygenation but potentially increase risk of air leak. Using an underwater seal to generate the pressure, or “Bubble CPAP,” generates small fluctuations around the set pressure which some believe offers additional advantage [93]. Using a flow driver to generate CPAP has the theoretical advantage of offloading expiratory work of breathing (the Coanda effect), although no important clinical differences have been shown among devices used to deliver CPAP, but the simplicity of bubble CPAP systems allows their use in low-income settings [94].…”

Section: Non-invasive Respiratory Supportmentioning

confidence: 99%

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

et al. 2019

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As management of respiratory distress syndrome (RDS) advances, clinicians must continually revise their current practice. We report the fourth update of “European Guidelines for the Management of RDS” by a European panel of experienced neonatologists and an expert perinatal obstetrician based on available literature up to the end of 2018. Optimising outcome for babies with RDS includes prediction of risk of preterm delivery, need for appropriate maternal transfer to a perinatal centre and timely use of antenatal steroids. Delivery room management has become more evidence-based, and protocols for lung protection including initiation of CPAP and titration of oxygen should be implemented immediately after birth. Surfactant replacement therapy is a crucial part of management of RDS, and newer protocols for its use recommend early administration and avoidance of mechanical ventilation. Methods of maintaining babies on non-invasive respiratory support have been further developed and may cause less distress and reduce chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease, although minimising time spent on mechanical ventilation using caffeine and, if necessary, postnatal steroids are also important considerations. Protocols for optimising general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome.

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Section: Non-invasive Respiratory Supportmentioning

confidence: 99%

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

et al. 2019

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“…In addition, while newborns in the control group were treated by non‐invasive bubble CPAP, previous comparison in preterm lambs were performed between NHFOV and endotracheal ventilation, which in itself is a major risk factor for BPD. Moreover, the presence of high frequency oscillations (between 15 and 30 Hz), which is inherent to bubble CPAP, may have reduced the difference between the nHFOV and control groups in the study by Zhu et al…”

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confidence: 95%

Non‐invasive high‐frequency oscillatory ventilation for preterm newborns: The time has come for consideration

Praud

Fortin-Pellerin

2017

Pediatric Pulmonology

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“…[8][9][10] In developed countries, CPAP failure is associated with greater morbidity; in developing countries, CPAP failure is associated with greater mortality. [11,12] More recently, bubble nCPAP has re-emerged as a potential strategy to address high nCPAP failure rates. [13] Although data are limited, neonates on bubble nCPAP had lower incidence of respiratory failure (tracheal intubation and mechanical ventilation) than did infants supported on ventilatorderived CPAP.…”

mentioning

confidence: 99%

“…[13] Although data are limited, neonates on bubble nCPAP had lower incidence of respiratory failure (tracheal intubation and mechanical ventilation) than did infants supported on ventilatorderived CPAP. [12,14] Despite evidence that bubble nCPAP may be advantageous for preterm infants, optimal delivery for newborns with respiratory distress is unknown. To address high failure rates associated with CPAP among preterm neonates, investigations of novel strategies to deliver more effective bubble nCPAP are warranted.…”

mentioning

confidence: 99%

“…[15] One potential strategy is with use of Seattle-PAP. [12,13,16,17] In general, bubble nCPAP delivery systems consist of six primary components: sources of air, oxygen, and other breathing gases, a blender to mix these gases together, a gas heater and humidifier, inspiratory and expiratory tubing (breathing circuit), a patient interface (e.g., bi-nasal prongs or nasal mask), and a pressure generator (e.g., bubbler device). The design of a bubbler device can take many forms, but is generally comprised of a tube with its distal end submerged in a body of water.…”

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confidence: 99%

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Evaluating the Efficacy of Seattle-PAP for the Respiratory Support of Premature Neonates: Study Protocol for a Randomized Controlled Trial

Backes

Naik

Hansen

et al. 2018

Preprint

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Background: At birth, the majority of neonates born at <30 weeks of gestation require respiratory support to facilitate transition and ensure adequate gas exchange. Although the optimal approach to the initial respiratory management is uncertain, the American Academy of Pediatrics endorses noninvasive respiratory support with nasal continuous positive airway pressure (nCPAP) for premature neonates with respiratory insufficiency. Despite evidence for its use, nCPAP failure, requiring intubation and mechanical ventilation is common. Recently, investigators have described a novel method to deliver bubble nCPAP, termed Seattle-PAP. While preclinical and pilot studies are encouraging with regard to the potential value of Seattle-PAP, a large trial is needed to compare Seattle-PAP directly with the current standard of care for bubble nCPAP (Fisher Paykel-CPAP; FP-CPAP). Methods: We designed a multicenter, non-blinded, randomized controlled trial that will enroll 230 premature infants (220/7 to 296/7 weeks of gestation). Infants will be randomized to receive Seattle-PAP or FP-CPAP. The primary outcome is respiratory failure requiring intubation and mechanical ventilation. Secondary outcomes include measures of short and long-term respiratory morbidity and cost effectiveness. Discussion: This trial will assess whether Seattle-PAP is more efficacious and cost effective than FP-CPAP in real-world practice among premature neonates. Trial Registration: This trial has been registered with the United States National Library of Medicine (www.clinicaltrials.gov, Trial Identifier #NCT03085329). Registered on 21 March 2017.

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Continuous Positive Airway Pressure Strategies with Bubble Nasal Continuous Positive Airway Pressure

Cited by 16 publications

References 23 publications

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

Non‐invasive high‐frequency oscillatory ventilation for preterm newborns: The time has come for consideration

Evaluating the Efficacy of Seattle-PAP for the Respiratory Support of Premature Neonates: Study Protocol for a Randomized Controlled Trial

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