Synchronized neonatal non-invasive ventilation-a pilot study: The graseby capsule with bi-level NCPAP

Abstract

The GC is a sensitive respiratory detection device; however, the GC/BNCPAP interface requires a minimum Ti of 0.3 sec and an adequate respiratory effort to achieve the desired pressure and to synchronously trigger the BNCPAP.

Breath detection by transcutaneous electromyography of the diaphragm and the Graseby capsule in preterm infants

“…Because the breath detection algorithm used in the Infant Flow ® SiPAP™ system was not available as standalone software, we assessed the trigger rate of the synchronized Biphasic mode by entering the GC signal obtained in spontaneous breathing preterm infants offline in an in vitro set‐up. The relatively low trigger rate of 67.8% found in this study is consistent with previous published data . However, up to now it remained unclear if this suboptimal triggering is a consequence of the technique used to detect spontaneous breathing, that is, a pneumatic capsule placed on the abdominal wall, or the algorithm used for breath detection that is incorporated in the system.…”

“…The relative high respiratory rate in our population could be a potential contributor to the suboptimal breath detection by the Infant Flow ® SiPAP™. However, other studies found trigger rates of 56 to 88% for this system in infants with mean respiratory rates ranging from 50 to 64 breaths per minute . Furthermore, the respiratory rate did not limit the detection rate in the new developed algorithm where 99.9% of the breaths were detected.…”

“…The relatively low trigger rate of 67.8% found in this study is consistent with previous published data. 6,7 However, up to now it remained unclear if this suboptimal triggering is a consequence of the technique used to detect spontaneous breathing, that is, a pneumatic capsule placed on the abdominal wall, or the algorithm used for breath detection that is incorporated in the system. To answer this question, we also entered the spontaneous breaths detected by dEMG in the Infant Flow ® SiPAP™ and found a similar trigger rate as for the GC signal.…”

“…The GC is placed on the abdominal wall of the infant where it detects pressure differences due to expansion of the abdomen during respiration, which can be used to trigger mechanical nIPPV inflations. However, previous studies have shown that detection of spontaneous breaths with the GC varies between 56% and 88% and it is unclear if this suboptimal detection is caused by the GC itself or the trigger algorithm . Furthermore, there is limited data on the delay time between the infant's onset of inspiration and its detection by the GC.…”

“…However, previous studies have shown that detection of spontaneous breaths with the GC varies between 56% and 88% and it is unclear if this suboptimal detection is caused by the GC itself or the trigger algorithm. [5][6][7] Furthermore, there is limited data on the delay time between the infant's onset of inspiration and its detection by the GC.…”