OBJECTIVE: To compare work of breathing and breathing asynchrony during bubble nasal continuous positive airway pressure (NCPAP) vs variable-flow (VF)-NCPAP in premature infants. STUDY DESIGN: We studied 18 premature infants of birth weight <1500 g who required NCPAP for mild respiratory distress. Each infant was studied on bubble and VF-NCPAP at 8, 6, 4, and 0 cm H2O. Tidal volumes were obtained by calibrated respiratory inductance plethysmography. Esophageal pressure estimated intrapleural pressure. Inspiratory and resistive work of breathing were calculated from pressure-volume data. Breathing asynchrony was assessed with phase angle. The results at all NCPAP levels were referenced to VF-NCPAP values at 8 cm H2O. RESULTS: Provision of NCPAP with either device decreased inspiratory work of breathing, tidal volume, and minute ventilation relative to NCPAP of 0 cm H2O. Bubble NCPAP did not decrease resistive work of breathing relative to 0 cm H2O. Resistive work of breathing (p=0.01), respiratory rate (p<0.03), and phase angle (p=0.002) were all greater with bubble compared to VF-NCPAP. CONCLUSION: The more labored and asynchronous breathing seen with bubble NCPAP may lead to higher failure rates over the long term than with VF-NCPAP.
RCT Entities:
OBJECTIVE: To compare work of breathing and breathing asynchrony during bubble nasal continuous positive airway pressure (NCPAP) vs variable-flow (VF)-NCPAP in premature infants. STUDY DESIGN: We studied 18 premature infants of birth weight <1500 g who required NCPAP for mild respiratory distress. Each infant was studied on bubble and VF-NCPAP at 8, 6, 4, and 0 cm H2O. Tidal volumes were obtained by calibrated respiratory inductance plethysmography. Esophageal pressure estimated intrapleural pressure. Inspiratory and resistive work of breathing were calculated from pressure-volume data. Breathing asynchrony was assessed with phase angle. The results at all NCPAP levels were referenced to VF-NCPAP values at 8 cm H2O. RESULTS: Provision of NCPAP with either device decreased inspiratory work of breathing, tidal volume, and minute ventilation relative to NCPAP of 0 cm H2O. Bubble NCPAP did not decrease resistive work of breathing relative to 0 cm H2O. Resistive work of breathing (p=0.01), respiratory rate (p<0.03), and phase angle (p=0.002) were all greater with bubble compared to VF-NCPAP. CONCLUSION: The more labored and asynchronous breathing seen with bubble NCPAP may lead to higher failure rates over the long term than with VF-NCPAP.
Authors: J Jane Pillow; Noah Hillman; Timothy J M Moss; Graeme Polglase; Geoff Bold; Chris Beaumont; Machiko Ikegami; Alan H Jobe Journal: Am J Respir Crit Care Med Date: 2007-04-12 Impact factor: 21.405
Authors: Fahmida Chowdhury; Abu Sadat Mohammad Sayeem Bin Shahid; Mosharrat Tabassum; Irin Parvin; Probir Kumar Ghosh; Mohammad Iqbal Hossain; Nur Haque Alam; A S G Faruque; Sayeeda Huq; Lubaba Shahrin; Nusrat Homaira; Zakiul Hassan; Zubair Akhtar; S Mah-E-Muneer; George J Fuchs; Tahmeed Ahmed; Mohammod Jobayer Chisti Journal: PLoS One Date: 2021-02-19 Impact factor: 3.240