Noninvasive Respiratory Support of Juvenile Rabbits by High-Amplitude Bubble Continuous Positive Airway Pressure

DiBlasi, Robert M; Zignego, Jay C; Tang, Dennis M.; Hildebrandt, J.; Smith, Charles V.; Hansen, Thomas N.; Richardson, C Peter

doi:10.1203/pdr.0b013e3181dcd580

Cited by 38 publications

(47 citation statements)

References 23 publications

(14 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With more area between the air-water seal (the size of the bubble breaking off the tube), a larger amount of energy is transmitted to the pressure waves traveling back through the system into the patient. This phenomenon was discussed by DiBlasi et al 22 in a study investigating highamplitude bubble CPAP in an attempt to explain the large ⌬P aw observed in a 135°expiratory limb configuration. As a result, by allowing more energy to transmit to the air column, there is a greater chance that more frequencies will receive sufficient energy to travel through the lung.…”

Section: Discussionmentioning

confidence: 96%

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

2014

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

Section: Discussionmentioning

confidence: 96%

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

2014

View full text Add to dashboard Cite

show abstract

“…The HAB-CPAP device, which has been described in greater detail previously (5), is similar to a B-CPAP device, with the modification that the angle of the gas exit tubing, or bubbler, can be adjusted (Fig. 1).…”

Section: Methodsmentioning

confidence: 99%

“…In a previous study, we demonstrated that HAB-CPAP could provide noninvasive support, via nasal prongs, to spontaneously breathing, lung-lavaged juvenile rabbits, with lower work of breathing and higher PaO 2 levels than were observed in the same animals supported with B-CPAP at identical mean airway pressures (MAPs) (5).…”

mentioning

confidence: 99%

Effective Gas Exchange in Paralyzed Juvenile Rabbits Using Simple, Inexpensive Respiratory Support Devices

et al. 2010

Self Cite

View full text Add to dashboard Cite

ABSTRACT:We have developed two devices: a high-amplitude bubble continuous positive airway pressure (HAB-CPAP) and an inexpensive bubble intermittent mandatory ventilator (B-IMV) to test the hypotheses that simple, inexpensive devices can provide gas exchange similar to that of bubble CPAP (B-CPAP) and conventional mechanical ventilation (CMV). Twelve paralyzed juvenile rabbits were intubated, stabilized on CMV, and then switched to CPAP. On identical mean airway pressures (MAPs), animals were unable to maintain pulse oximeter oxygen saturation (SpO 2 ) Ͼ80% on conventional B-CPAP, but all animals oxygenated well (97.3 Ϯ 2.1%) on HAB-CPAP. In fact, arterial partial pressures of O 2 (PaO 2 ) were higher during HAB-CPAP than during CMV (p ϭ 0.01). After repeated lung lavages, arterial partial pressures of CO 2 (PaCO 2 ) were lower with B-IMV than with CMV (p Ͻ 0.0001), despite identical ventilator settings. In lavaged animals, when HAB-CPAP was compared with CMV at the same MAP and 100% O 2 , no differences were observed in PaO 2 , but PaCO 2 levels were higher with HAB-CPAP (70 Ϯ 7 versus 50 Ϯ 5 mm Hg; p Ͻ 0.05). Arterial blood pressures were not impaired by HAB-CPAP or B-IMV. The results confirm that simple inexpensive devices can provide respiratory support in the face of severe lung disease and could extend the use of respiratory support for preterm infants into severely resourcelimited settings. (Pediatr Res 68: 526-530, 2010) I nfant mortality caused by respiratory distress syndrome in the United States decreased from ϳ268 in 100,000 live births in 1971 to 98 in 100,000 live births in 1985 (1) and 17 in 100,000 live births in 2007 (2). The decrease in mortality from 1971 to 1985 was, in large part, due to the development and widespread availability of mechanical ventilators and continuous positive airway pressure (CPAP) devices designed to assist lung recruitment and gas exchange in newborn infants in respiratory distress. However, Ͼ4 million infants die throughout the world each year, with 1 million dying principally from respiratory insufficiency (3,4), largely because of the lack in resource-limited countries of the respiratory support devices and technologies that are commonly used in more affluent societies.Modern ventilators are expensive to purchase, which limits availability in resource-limited countries. Even if the devices are donated, the need for highly trained personnel to operate, maintain, and repair the ventilators effectively prevent significant use of modern ventilators in most facilities. Practical methods for respiratory support of prematurely born infants could save hundreds of thousands of newborn lives each year.In an effort to bridge the gap between the need for less expensive, simpler, more practical approaches to respiratory support and the need for greater range of simple support methods, we have developed two novel devices that can be used separately or together to provide a broad range of respiratory support for infants.One device, termed high-amplitude bubble continuous positive...

show abstract

“…In a neonatal lung model affixed with leaky nasal prongs, the high-amplitude bubble-CPAP device adjusted with the outlet tubing at 135°, in relation to the water surface level, was found to deliver similar tidal volumes as those previously measured during HFOV in infants. 45 In addition, it was demonstrated that high-amplitude bubble-CPAP provides noninvasive support, via nasal prongs, to spontaneously breathing, lung-lavaged juvenile rabbits with lower WOB (P Ͻ .001) and higher P aO 2 (P Ͻ .007) than were observed in the same animals supported with bubble nasal CPAP at identical mean airway pressures. 45 Two rabbits supported by high-amplitude bubble-CPAP became apneic with normal P aCO 2 and vital signs.…”

Section: Noninvasive Ventilationmentioning

confidence: 96%

“…45 In addition, it was demonstrated that high-amplitude bubble-CPAP provides noninvasive support, via nasal prongs, to spontaneously breathing, lung-lavaged juvenile rabbits with lower WOB (P Ͻ .001) and higher P aO 2 (P Ͻ .007) than were observed in the same animals supported with bubble nasal CPAP at identical mean airway pressures. 45 Two rabbits supported by high-amplitude bubble-CPAP became apneic with normal P aCO 2 and vital signs. High-amplitude bubble-CPAP may represent a relatively simple new strategy for supporting a greater fraction of neonates who would otherwise fail nasal CPAP and require invasive mechanical ventilation.…”

Section: Noninvasive Ventilationmentioning

confidence: 96%

Respiratory Care Year in Review 2010: Part 2. Invasive Mechanical Ventilation, Noninvasive Ventilation, Pediatric Mechanical Ventilation, Aerosol Therapy

et al. 2011

View full text Add to dashboard Cite

SummaryThe purpose of this paper is to review the recent literature related to invasive mechanical ventilation, NIV, pediatric mechanical ventilation, and aerosol therapy. Topics covered related to invasive mechanical ventilation topics include the role of PEEP in providing lung protection during mechanical ventilation, unconventional modes for severe hypoxemia, and strategies to improve patient-ventilator interactions. Topics covered related to NIV include real-life NIV use, NIV and extubation failure, and NIV and pandemics. For pediatric mechanical ventilation, the topics addressed are NIV, invasive respiratory support, and inhaled nitric oxide. Topics covered related to aerosol therapy include short-acting ␤-adrenergic agents, long-acting ␤-adrenergic agents, longacting antimuscarinic agents, inhaled corticosteroid therapy, phosphodiesterase type 4 (PDE4) inhibitors, long-acting ␤-adrenergic plus inhaled corticosteroid, long-acting antimuscarinic plus RESPIRATORY CARE • MAY 2011 VOL 56 NO 5 667 inhaled corticosteroid, nebulized hypertonic saline, inhaled mannitol, and inhaled antibiotic therapy. These topics were chosen and reviewed in a manner that is most likely to have interest to the readers of RESPIRATORY CARE.

show abstract

Noninvasive Respiratory Support of Juvenile Rabbits by High-Amplitude Bubble Continuous Positive Airway Pressure

Cited by 38 publications

References 23 publications

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

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

Effective Gas Exchange in Paralyzed Juvenile Rabbits Using Simple, Inexpensive Respiratory Support Devices

Respiratory Care Year in Review 2010: Part 2. Invasive Mechanical Ventilation, Noninvasive Ventilation, Pediatric Mechanical Ventilation, Aerosol Therapy

Contact Info

Product

Resources

About