Tidal volume transmission during non-synchronized nasal intermittent positive pressure ventilation via RAM.sup.[R] cannula

• Published in: Journal of perinatology Vol. 39; no. 5; p. 723
• 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: Nature Publishing Group 01-05-2019
• Subjects: Continuous positive airway pressure; Equipment and supplies; Inflation (Economics); Neonatal intensive care; Newborn infants; Pediatric research; Physiological aspects; Pulmonary ventilation
• ISSN: 0743-8346
• DOI: 10.1038/s41372-019-0333-x

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.sup.® 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 [plus or minus] 0.22 in NIPPV inflations associated with patient effort and 0.27 [plus or minus] 0.15 in spontaneous breaths without ventilator assistance (p = 0.82). Tidal volumes during ventilator-only inflations were 0.06 [plus or minus] 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.