Effects of Condensate in the Exhalation Limb of Neonatal Circuits on Airway Pressure During Bubble CPAP

Youngquist, Tiffany M.; Richardson, C Peter; DiBlasi, Robert M

doi:10.4187/respcare.02322

Cited by 35 publications

(19 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A validated anatomically correct physical model 8 (Fig. 1) and the newborn and infant-sized RAM cannulas were secured (Neotech, Valencia, California).…”

Section: Nasal Airway Modelmentioning

confidence: 99%

“…Resistance was set at 150 cm H 2 O/L/s, and compliance was set at 0.5 mL/cm H 2 O. The active breathing model had a set breathing frequency of 70 breaths/min, an inspiratory time of 0.30 s, 8,9 and a simulated esophageal pressure of Ϫ10 cm H 2 O 8,9 to yield a tidal volume of 5 mL.…”

Section: Lung Modelmentioning

confidence: 99%

“…Each combination of CPAP level and flow was tested with each of the interfaces, the Fisher & Paykel size 4030, newborn and infant-sized RAM cannulas connected to the nasal airway model 8 and the Babi-Plus bubble CPAP system.…”

Section: Simulator/bubble Cpap System Interfacementioning

confidence: 99%

See 2 more Smart Citations

Evaluating the Effect of Flow and Interface Type on Pressures Delivered With Bubble CPAP in a Simulated Model

Bailes

Firestone²,

Dunn³

et al. 2015

Respir Care

View full text Add to dashboard Cite

BACKGROUND: Bubble CPAP, used for spontaneously breathing infants to avoid intubation or postextubation support, can be delivered with different interface types. This study compared the effect that interfaces had on CPAP delivery. We hypothesized that there would be no difference between set and measured levels between interface types. METHODS: A validated preterm infant nasal airway model was attached to the ASL 5000 breathing simulator. The simulator was programmed to deliver active breathing of a surfactant-deficient premature infant with breathing frequency at 70 breaths/min inspiratory time of 0.30 s, resistance of 150 cm H 2 O/L/s, compliance of 0.5 mL/cm H 2 O, tidal volume of 5 mL, and esophageal pressure of ؊10 cm H 2 O. Nasal CPAP prongs, size 4030, newborn and infant RAM cannulas were connected to a nasal airway model and a bubble CPAP system. CPAP levels were set at 4, 5, 6, 7, 8, and 9 cm H 2 O with flows of 6, 8, and 10 L/min each. Measurements were recorded after 1 min of stabilization. The analysis was performed using SAS 9.4. The Kolmogorov-Smirnov test assessed normality of the data. The Friedman test was used to compare non-normally distributed repeated measures. The Wilcoxon signed-rank test was used to conduct post hoc analysis. All tests were 2-sided, and P values of <.05 were considered as indicating significant differences unless otherwise indicated. RESULTS: At lower set CPAP levels, 4 -6 cm H 2 O, measured CPAP dropped precipitously with the nasal prongs with the highest flow setting. At higher CPAP levels, 7-9 cm H 2 O measured CPAP concomitantly increased as the flow setting increased. Statistically significant differences in set and measured CPAP occurred for all devices across all CPAP levels, with the measured CPAP less than set for all conditions, P < .001. CONCLUSIONS: Set flow had a profound effect on measured CPAP. The concomitant drop in measured pressure with high and low flows could be attributed to increased resistance to spontaneous breathing or insufficient flow to meet inspiratory demand. Clinicians should be aware of the effect that the interface and flow have on CPAP delivery.

show abstract

“…A validated anatomically correct physical model 8 (Fig. 1) and the newborn and infant-sized RAM cannulas were secured (Neotech, Valencia, California).…”

Section: Nasal Airway Modelmentioning

confidence: 99%

Section: Lung Modelmentioning

confidence: 99%

See 1 more Smart Citation

Evaluating the Effect of Flow and Interface Type on Pressures Delivered With Bubble CPAP in a Simulated Model

Bailes

Firestone²,

Dunn³

et al. 2015

Respir Care

View full text Add to dashboard Cite

show abstract

“…This model has been described in detail elsewhere. 9 The lung model consisted of a Silastic infant test lung (compliance of 0.47 mL/cm H 2 O and resistance of 150 cm H 2 O/L/s; model 191, Maquet, Wayne, New Jersey) positioned inside a plethysmograph (14-cm diameter ϫ 15-cm height; IngMar Medical, Pittsburgh, Pennsylvania) that was surrounded by steel wool to maintain isothermal conditions. The plethysmograph was calibrated to enable conversion of pressure changes inside the plethysmograph to changes in volume of the Silastic test lung.…”

Section: Nasal Airway/lung Modelmentioning

confidence: 99%

Volume Oscillations Delivered to a Lung Model Using 4 Different Bubble CPAP Systems

2014

Self Cite

View full text Add to dashboard Cite

The major finding of this study is that bubble CPAP can provide measureable ventilation effects in an infant lung model. We speculate that the differences noted in ⌬V between the different devices are a combination of the circuit/nasal prong configuration, bubbler configuration, and frequency of oscillations. Additional testing is needed in spontaneously breathing infants to determine whether a physiologic benefit exists when using the different bubble CPAP systems.

show abstract

“…3 In this month's issue of RESPIRATORY CARE, Youngquist and colleagues report an elegant set of experiments evaluating the effect of a different kind of "noise" on the pressure delivered to the airway in infants receiving bubble CPAP. 7 For most infants receiving positive-pressure ventilation, whether from traditional mechanical ventilators or bubble CPAP devices, condensate forms in the expiratory limb of the circuit as warm humidified gas is exposed to room temperature tubing. As the authors note, if there is a low point in the expiratory tubing, a considerable amount of condensate will form and "bounce/bubble" around in the tubing as more gas flows past.…”

mentioning

confidence: 99%

Bubble CPAP: Not All Bubbling Is Good Bubbling

Mastropietro

2013

Respir Care

View full text Add to dashboard Cite

Effects of Condensate in the Exhalation Limb of Neonatal Circuits on Airway Pressure During Bubble CPAP

Cited by 35 publications

References 17 publications

Evaluating the Effect of Flow and Interface Type on Pressures Delivered With Bubble CPAP in a Simulated Model

Evaluating the Effect of Flow and Interface Type on Pressures Delivered With Bubble CPAP in a Simulated Model

Volume Oscillations Delivered to a Lung Model Using 4 Different Bubble CPAP Systems

Bubble CPAP: Not All Bubbling Is Good Bubbling

Contact Info

Product

Resources

About