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Effects of synchronisation during SiPAP-generated nasal intermittent positive pressure ventilation (NIPPV) in preterm infants.
MedLine Citation:
PMID:  24942746     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: The SiPAP flow driver (Care Fusion, Dublin, Ohio, USA) offers synchronised nasal intermittent positive pressure ventilation (sNIPPV) using an abdominal capsule. This study aims to describe the accuracy and effects of synchronised NIPPV using SiPAP in preterm infants.
DESIGN: Ten infants, born <28 weeks' gestation, receiving synchronised SiPAP-generated NIPPV, in 'biphasic trigger' mode, were observed. Abdominal capsule signals, delivered pressures, respiratory pattern and oxygen saturations were recorded. Tidal volume (VT), apnoeas, proportion of breaths supported by SiPAP and time between inspiration onset and SiPAP pressure rise were analysed.
RESULTS: Infants were of median 26(+0) weeks' gestational age and birth weight 776 g. Mean (SD) respiratory rate (RR) was 53 (14)/min. 82% (17) of spontaneous breaths triggered a SiPAP pressure peak. Mean time between inspiration and SiPAP pressure rise was 28 (20) ms. There was no difference in VT when breaths triggered a SiPAP pressure peak compared with breaths without a pressure peak. No VT was generated by pressure peaks delivered during apnoea. Capsule signals were not recognised following >10% of breaths, resulting in asynchronous NIPPV delivery. Movements resulted in irregular SiPAP pressures and desaturation. When the RR was faster, >55/min, breaths irregularly triggered a SiPAP pressure peak (p=0.003). Compared with times when every breath resulted in a pressure peak, lower mean pressures were achieved, 7.9 vs 8.4 cm H2O (p=0.02).
CONCLUSIONS: The SiPAP synchronisation system triggered rapidly with most spontaneous breaths, but did not result in larger tidal volumes. When the RR was >55/min, the SiPAP delivered fewer pressure peaks at lower pressures.
Authors:
L S Owen; C J Morley; P G Davis
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-18
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  -     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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