Tidal volume transmission during non-synchronized nasal intermittent positive pressure ventilation via RAM® cannula

Tidal volume transmission during non-synchronized nasal intermittent positive pressure ventilation via RAM® cannula

Background Nasal intermittent positive pressure ventilation (NIPPV) is a widely used mode of support in neonates, during which ventilator inflations may or may not coincide with spontaneous breathing. Objective We tested the hypothesis that inflations delivered with NIPPV via RAM ® cannula and not a...

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Bibliographic Details
Published in:Journal of perinatology Vol. 39; no. 5; pp. 723 - 729
Main Authors: Matlock, David N., Bai, Shasha, Weisner, Michael D., Comtois, Norman, Beck, Jennifer, Sinderby, Christer, Courtney, Sherry E.
Format: Journal Article
Language:English
Published: New York Nature Publishing Group US 01-05-2019
Nature Publishing Group
Subjects:
692/308/409
692/699/1785
692/700/1720
Cannula
Cannulae
Cross-Over Studies
Diaphragm
Female
Gestational Age
Humans
Inductance
Infant
Infant, Newborn
Infant, Premature - physiology
Intensive Care, Neonatal - methods
Intermittent Positive-Pressure Ventilation
Male
Mechanical ventilation
Medical materials
Medicine
Medicine & Public Health
Neonates
Pediatric Surgery
Pediatrics
Plethysmography
Pressure
Retrospective Studies
Tidal Volume
Ventilation
Ventilators
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Summary:Background Nasal intermittent positive pressure ventilation (NIPPV) is a widely used mode of support in neonates, during which ventilator inflations may or may not coincide with spontaneous breathing. Objective We tested the hypothesis that inflations delivered with NIPPV via RAM ® cannula and not accompanied by patient effort produce minimal tidal volume as measured by respiratory inductance plethysmography. Design/Methods Fourteen subjects were monitored while receiving NIPPV. We compared tidal volumes during ventilator-supported breaths, unsupported breaths, and ventilator inflations not accompanied by patient effort (defined using electrical activity of the diaphragm). Results Mean tidal volumes in arbitrary units were 0.30 ± 0.22 in NIPPV inflations associated with patient effort and 0.27 ± 0.15 in spontaneous breaths without ventilator assistance ( p  = 0.82). Tidal volumes during ventilator-only inflations were 0.06 ± 0.04 ( p  < 0.005 vs. both ventilator-assisted and unassisted efforts). Conclusions NIPPV via RAM cannula produces minimal, clinically insignificant tidal volumes during non-spontaneous inflations.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ISSN:0743-8346
1476-5543
DOI:10.1038/s41372-019-0333-x