Document Detail


Nasal continuous positive airway pressure (CPAP) for the respiratory care of the newborn infant.
MedLine Citation:
PMID:  19712498     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Nasal continuous positive airway pressure (CPAP) is a noninvasive form of respiratory assistance that has been used to support spontaneously breathing infants with lung disease for nearly 40 years. Following reports that mechanical ventilation contributes to pulmonary growth arrest and the development of chronic lung disease, there is a renewed interest in using CPAP as the prevailing method for supporting newborn infants. Animal and human research has shown that CPAP is less injurious to the lungs than is mechanical ventilation. The major concepts that embrace lung protection during CPAP are the application of spontaneous breathing at a constant distending pressure and avoidance of intubation and positive-pressure inflations. A major topic for current research focuses on whether premature infants should be supported initially with CPAP following delivery, or after the infant has been extubated following prophylactic surfactant administration. Clinical trials have shown that CPAP reduces the need for intubation/mechanical ventilation and surfactant administration, but it is still unclear whether CPAP reduces chronic lung disease and mortality, compared to modern lung-protective ventilation techniques. Despite the successes, little is known about how best to manage patients using CPAP. It is also unclear whether different strategies or devices used to maintain CPAP play a role in improving outcomes in infants. Nasal CPAP technology has evolved over the last 10 years, and bench and clinical research has evaluated differences in physiologic effects related to these new devices. Ultimately, clinicians' abilities to perceive changes in the pathophysiologic conditions of infants receiving CPAP and the quality of airway care provided are likely to be the most influential factors in determining patient outcomes.
Authors:
Robert M Diblasi
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Respiratory care     Volume:  54     ISSN:  0020-1324     ISO Abbreviation:  -     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-28     Completed Date:  2009-10-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1209-35     Citation Subset:  IM    
Affiliation:
Center for Developmental Therapeutics, Seattle Children's Research Institute, 1900 Ninth Avenue, Seattle WA 98101, USA. robert.diblasi@seattlechildrens.org
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MeSH Terms
Descriptor/Qualifier:
Continuous Positive Airway Pressure / instrumentation*,  methods*
Humans
Infant, Newborn
Respiratory Distress Syndrome, Newborn / therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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