The Science Journal of the American Association for Respiratory Care

2009 OPEN FORUM Abstracts

CPAP EFFECT OF HIGH FLOW NASAL CANNULA IN PEDIATRIC PATIENTS

Jason Amadei2,1, Shannon Cook2, Teresa A. Volsko1, Kathy Fedor3, Robert L. Chatburn2; 1Health Professions, Youngstown State University, Youngstown, OH; 2Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH; 3Pediatric Respiratory Therapy, Cleveland Clinic Foundation, Cleveland, OH

BACKGROUND: Limited data are available to describe the CPAP effects that can be expected when using high flows with a nasal cannula. The purpose of this study was to describe the relationship between the pressure generated at the airway opening and flow through a standard nasal cannula in simulated preterm, infant and pediatric models. We hypothesized the positive pressure generated by a standard cannula at flow rates greater than 2 L/min will be minimal and clinically insignificant. METHODS: Nares were simulated by drilling holes in plastic fixtures. The size of the nares corresponded with the Airlife nares template (preterm, infant and pediatric). The fixtures were connected to an ASL 5000 lung simulator (Ingmar Medical). An active lung model simulated spontaneous breathing adjusted to deliver tidal volumes of 3, 6, 9, and 12 mL. Lung compliance and resistance were standardized at 0.5 mL/cm H2O and 125 cm H2O/L/sec., respectively. Appropriately sized nasal cannulae were inserted in the fixtures. Cannula flow was adjusted from 2 – 6 L/min in 1 L/min increments. Data were averaged over twenty breaths. Mean airway pressure and %change in tidal volume were recorded. Differences in mean values were evaluated using one-way ANOVA. Statistical significance was set at P < 0.05. RESULTS: Values summarized over all volumes and flows are shown in Table 1. The greatest effect on tidal volume and pressure change was with the preterm model among the range of flows. CONCLUSIONS:Clinically important pressures were not generated by the use of high flows with a standard nasal cannula. Although statistically significant, differences in spontaneous tidal volume for each of the models across the range of flows were negligible. Sponsored Research - None

Table 1.

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