Dynamic surface tension of natural surfactant extract under superimposed oscillations

Reddy, Prasika I.; Al‐Jumaily, Ahmed M.; Bold, Geoff T.

doi:10.1016/j.jbiomech.2010.09.002

Cited by 16 publications

(9 citation statements)

References 20 publications

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“…Surface tension decreased with increasing frequencies and reached a minimum value of about 7 dyne/cm (7 mN/m) at extremely supraphysiologic frequencies (70–80 Hz). According to this study, surface tension of 15–30 dyne/cm (15–30 mN/m) is reached with frequencies usually applied when using HFOV in neonates and infants 28. Consistent values have been found testing surfactant from bronchoalveolar lavage recovered from infants with severe acute RDS under invasive HFOV 29.…”

Section: Biological Effects Of Nhfovsupporting

confidence: 73%

“…They can be related to the oscillations or to the use of a non-invasive interface. Regarding the first type of effect, Reddy et al 28 showed that superimposing oscillations over the tidal volume excursions in a surfactant bubble lowers surface tension significantly more than using tidal volume excursion alone. Surface tension decreased with increasing frequencies and reached a minimum value of about 7 dyne/cm (7 mN/m) at extremely supraphysiologic frequencies (70–80 Hz).…”

Section: Biological Effects Of Nhfovmentioning

confidence: 99%

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Non-invasive high-frequency oscillatory ventilation in neonates: review of physiology, biology and clinical data

Luca

Dell’Orto

2016

Arch Dis Child Fetal Neonatal Ed

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Non-invasive high-frequency oscillatory ventilation (NHFOV) consists of the application of a bias flow generating a continuous distending positive pressure with superimposed oscillations, which have constant frequency and active expiratory phase. NHFOV matches together the advantages of high-frequency ventilation (no need for synchronisation, high efficacy in removing CO 2 ) and nasal continuous positive airway pressure (CPAP) (non-invasive interface, increase in functional residual capacity allowing oxygenation to improve). There is enough clinical expertise demonstrating that NHFOV may be tried in some selected cases, in whom CPAP or conventional non-invasive ventilation have failed. Nonetheless, there are no clear data about its clinical usefulness and there is a need for randomised controlled studies. Our purpose is to review the physiology and biological effects of NHFOV, to present the current clinical evidence on its use, to provide some guiding principles to clinicians and suggest directions for further research.

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Section: Biological Effects Of Nhfovsupporting

confidence: 73%

Section: Biological Effects Of Nhfovmentioning

confidence: 99%

Non-invasive high-frequency oscillatory ventilation in neonates: review of physiology, biology and clinical data

Luca

Dell’Orto

2016

Arch Dis Child Fetal Neonatal Ed

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“…One main issue when using noninvasive ventilation in small infants is the difficult patient‐ventilator synchronization, which is not needed during NHFOV. De Luca et al showed how high frequency oscillations are superimposed to spontaneous breathing, thus contributing to gas exchange . This seems consistent with animal data showing that nasal HFOV reduces phasic glottic constriction and improves patient‐ventilator interaction .…”

supporting

confidence: 66%

“…The two techniques have been combined into the noninvasive oscillatory ventilation (NHFOV), that is a noninvasive ventilatory mode allowing to apply an oscillatory pressure waveform with an active expiratory phase over the spontaneous tidal volume excursion . The rationale behind the use of NHFOV is that superimposing oscillations over the tidal breathing may lower surface tension, increases lung volume and improves gas exchange . NHFOV is aimed at maximizing the advantages of high frequency ventilation with the use of a noninvasive, dedicated interface in order to avoid tracheal intubation and its related complications.…”

mentioning

confidence: 99%

Noninvasive oscillatory ventilation (NHFOV) in infants: Another brick in the wall of paediatric noninvasive ventilation?

2016

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“…5,7 BnCPAP promotes differentiation and maturation in fetal lungs. 30 Airway vibrations caused by bubbling may improve lung mechanics 28,31,32 and, in contrast to ventilator-driven nasal CPAP, improve oxygenation. 33 In addition to bnCPAP we instituted early surfactant therapy in the delivery room, with rapid extubation to bnCPAP for babies with substantial respiratory distress.…”

Section: Discussionmentioning

confidence: 99%

Bubble Nasal CPAP, Early Surfactant Treatment, and Rapid Extubation Are Associated With Decreased Incidence of Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Newborns: Efficacy and Safety Considerations

et al. 2013

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BACKGROUND: Current literature has been inconsistent in demonstrating that minimizing the duration of mechanical ventilation in very-low-birth-weight (VLBW) newborns reduces lung damage. OBJECTIVE: To determine if introduction of bubble nasal CPAP (bnCPAP), early surfactant treatment, and rapid extubation (combined bnCPAP strategy) in our community-based neonatal ICU reduced bronchopulmonary dysplasia (BPD). METHODS: This was a 7-year retrospective, single-institution review of respiratory outcomes in 633 VLBW babies before and after introduction of the combined bnCPAP strategy. Coincident changes in newborn care were taken into account with a logistic regression model. RESULTS: The average percentage of VLBW newborns with BPD decreased to 25.8% from 35.4% (P ‫؍‬ .02), reaching a minimum in the last post-bnCPAP year of 22.1% (P ‫؍‬ .02). When other coincident changes in newborn care during the study years were taken into account, VLBW babies in the post-bnCPAP years had a 43% lower chance of developing BPD (P ‫؍‬ .003, odds ratio 0.43, 95% CI 0.25-0.75). Decreases occurred in mechanical ventilation and the percentage of infants discharged on diuretics and on supplemental oxygen. Among the subset of extremely-low-birth-weight newborns, improved respiratory outcomes in the post-bnCPAP years, as compared to outcomes in the pre-bnCPAP years, included an increase in the percentage alive and off mechanical ventilation at 1 week postnatal age (P < .001), a more rapid extubation rate (P < .03), a decrease in the median days on mechanical ventilation (P ‫؍‬ .002), and a decrease in the percentage with BPD plus died (P ‫؍‬ .01). Post-bnCPAP extremely-low-birth-weight babies had a statistically significant decrease in retinopathy of prematurity, an increase in low-grade intraventricular hemorrhage, and a decrease in ductal ligations. CONCLUSIONS: A combined BnCPAP strategy may contribute to a reduction of BPD, after adjusting for concurrent treatments.

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Dynamic surface tension of natural surfactant extract under superimposed oscillations

Cited by 16 publications

References 20 publications

Non-invasive high-frequency oscillatory ventilation in neonates: review of physiology, biology and clinical data

Non-invasive high-frequency oscillatory ventilation in neonates: review of physiology, biology and clinical data

Noninvasive oscillatory ventilation (NHFOV) in infants: Another brick in the wall of paediatric noninvasive ventilation?

Bubble Nasal CPAP, Early Surfactant Treatment, and Rapid Extubation Are Associated With Decreased Incidence of Bronchopulmonary Dysplasia in Very-Low-Birth-Weight Newborns: Efficacy and Safety Considerations

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