| Effects of imposed resistance on tidal volume with 5 neonatal nasal continuous positive airway pressure systems. | |
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MedLine Citation:
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PMID: 20420723 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Neonates with respiratory distress syndrome are often treated with nasal continuous positive airway pressure (CPAP). Nasal CPAP methods include electronic feedback control, underwater seal, flow opposition, and flow opposition with fluidic flow reversal on expiration. Few studies have compared those modes, and the results have been contradictory. METHODS: We compared the effect of resistive load on simulated tidal volume (V(T)) with 5 neonatal nasal CPAP systems: Fisher and Paykel nasal CPAP tubing with Maquet Servo-i ventilator in NIV CPAP mode; Cardinal Health AirLife nasal CPAP system; Fisher and Paykel nasal CPAP tubing with water-seal pressure generator; AirLife infant nasal CPAP generator kit; and Hamilton Medical Arabella fluidic nasal CPAP generator. The lung simulator settings were: compliance 0.5 mL/cm H2O, resistance 125 H2O/L/s, sinusoidal patient-effort range 6.5-26 cm H2O, rise 25%, hold 0%, release 25%, respiratory rate 65 breaths/min. We compared the mean values from 10 breaths. RESULTS: The mean inspiratory pressure drop and V(T) difference (compared to the simulator alone, unloaded) increased with V(T), respectively, from 0.32 cm H2O to 1.73 cm H2O, and from -0.04 mL to -0.40 mL. Flow opposition had the smallest pressure drop (from 0.10 cm H2O to 0.64 cm H2O, P < .001). At V(T) of < or = 6 mL, the bubble nasal CPAP's pressure drop was largest (P < .001), whereas at V(T) of > or = 9 mL the electronic nasal CPAP's pressure drop was largest (P < .001). All systems except the ventilator did not have an average end-expiratory pressure of the targeted 5 cm H2O. CONCLUSIONS: The differences in these nasal CPAP systems correlate with the differences in unassisted V(T) due to loading effects. The ventilator imposed the least load, and the AirLife nasal CPAP system imposed the most. |
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Authors:
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Shannon E Cook; Katherine L Fedor; Robert L Chatburn |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Respiratory care Volume: 55 ISSN: 0020-1324 ISO Abbreviation: Respir Care Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-04-27 Completed Date: 2010-07-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7510357 Medline TA: Respir Care Country: United States |
Other Details:
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Languages: eng Pagination: 544-8 Citation Subset: IM |
Affiliation:
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Respiratory Institute, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Airway Resistance
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physiology* Continuous Positive Airway Pressure / instrumentation* Equipment Design Humans Infant, Newborn Nose Respiratory Distress Syndrome, Newborn / physiopathology, therapy* Tidal Volume / physiology* Ventilators, Mechanical* Work of Breathing / physiology* |
| Comments/Corrections | |
Comment In:
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Respir Care. 2010 May;55(5):638-9
[PMID:
20420737
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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