David N Matlock1,2, Shasha Bai3, Michael D Weisner4, Norman Comtois5, Jennifer Beck5,6,7,8, Christer Sinderby5,6,8, Sherry E Courtney9. 1. University of Arkansas for Medical Sciences, 4301 W. Markham Street, Slot 512-5B, Little Rock, AR, 72205, USA. DMatlock@uams.edu. 2. University of Arkansas for Medical Sciences, Little Rock, AR, USA. DMatlock@uams.edu. 3. Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, OH, USA. 4. Equilibrated Bio Systems, Inc., Smithtown, NY, USA. 5. Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada. 6. Department of Medicine and Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. 7. Department of Pediatrics, University of Toronto, Toronto, ON, Canada. 8. Institute for Biomedical Engineering and Science Technology (iBEST) at Ryerson University and St. Michael's Hospital, Toronto, ON, Canada. 9. University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Abstract
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.
RCT Entities:
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.