The Science Journal of the American Association for Respiratory Care

2007 OPEN FORUM Abstracts

ADULT VS INFANT HFOV CIRCUITS A COMPARISON STUDY OF POWER REQUIREMENTS FOR AMPLITUDE DELIVERY ACROSS THE MAP CONTINUUM

J. Glass1, S. Gulosh1, B. K. Walsh1


Background
Parent-infant bonding plays a significant role in improved developmental outcomes in the VLBW population. One of the problems experienced in our institution has been the difficulty of skin-to-skin contact for parents of infants requiring HFOV primarily because of the length of the infant oscillator circuit. We hypothesized that if the adult circuit was calibrated according to manufacturer’s specifications on the infant oscillator there would be no clinically significant difference in the power requirements to deliver amplitudes at any of the commonly used MAP’s and that the adult circuit would provide similar heat and humidity as the infant circuit.

Methods
We compared 4 Sensormedics 3100A oscillators using the same infant and adult circuits on each machine. Each circuit was calibrated on each machine according to manufacturer’s specifications. The circuits were then heated and humidified with the Fisher & Paykel 850 humidification system until the humidifier reached 37 degrees C. Power readings were taken on the following parameters: MAP-7, 9, 11, 13, 15, 18, 21; Amplitude-20, 25, 30, 35, 40, 45; Hz 15, 12. Bias flow was initially set at 20 LPM . When obtaining power readings at the lower MAPs / higher amplitudes, both the infant and adult circuits required a reduction in bias flow. Relative humidity and temperature were measured at the patient wye for a period of 30 seconds at the end of each run or when it was necessary to reduce bias flow to achieve MAP/amplitude utilizing a high performance digital hygrometer. The circuits and humidifier chambers were allowed a minimum of 24 hours to cool and dry between machine trials.

Results
Statistical analysis of the raw data was performed utilizing the Signed Rank test. There was a statistical difference (p<0.001) in the power readings between the adult and infant circuits. Relative humidity was consistent at 98%. There was a statistical difference (p<0.001) for temperature as well.

Conclusion
When looking at the raw data, we were surprised to find that it took less power for amplitude for the adult circuit. The adult circuit also had consistently higher temperature readings which may be related to the placement of the heated wire in the inspiratory limb. Even though there was a statistical difference between the infant and adult circuit, we believe that our hypothesis is correct and that the adult circuit can be used successfully on the infant oscillator.


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