The Science Journal of the American Association for Respiratory Care

2010 OPEN FORUM Abstracts

AIRWAY (PAW) AND LUNG MODEL (PLUNG) PRESSURE STABILITY IN TWO NASAL BUBBLE CONTINUOUS POSITIVE AIRWAY PRESSURE (B-CPAP) SYSTEMS.

Dave N. Crotwell, Rob DiBlasi; Respiratory Care, Seattle ChildrenÂ’s Hospital and Research Institute, Seattle, WA

BACKGROUND: B-CPAP is a non-invasive respiratory support strategy that is widely used in spontaneously breathing premature infants. We designed a descriptive study to compare differences between the set and measured pressures using two different systems during B-CPAP. METHODS: An anatomically accurate infant nasal airway model, fabricated using a 3D printer and dimensions obtained from a CT-scan of a preemie, was attached to a spontaneously breathing test lung (ASL 5000, Ingmar Medical; settings: RR 50 and Tidal Volume 5 mL). The nasal airway model was affixed with nasal prongs (Argyle Small, Sherwood Medical) and attached to the following B-CPAP systems: 1) Babi.plus (A Plus Medical); and 2) Homemade B-CPAP (HM B-CPAP). The Babi.Plus controls B-CPAP with an adjustable labeled dial that regulates depth of the distal bubbler. The HM B-CPAP device controls pressure by manually adjusting the depth of the distal tubing and confirming the depth with a measuring tape (6cm=6cmH2O). Bias flow in each system was set at 6 L/min. Nasal airway (PAW; Criterion 40, Respironics) and lung model (PLUNG;ASL 5000) pressures were measured simultaneously while varying the B-CPAP settings between 4-10 cmH2O. RESULTS: (Figure below). CONCLUSION/DISCUSSION: These data suggest that both B-CPAP systems provided similar pressure stabilization, as noted by the respective PAW and PLUNG measurements. However, in most cases, the PLUNG pressures correlated with the set B-CPAP level better than did PAW. Although we did not use the same pressure measurement device, per location, we suspect that the observed pressure drop across the anatomic infant nasal airway is related to attenuation of the airway pressure oscillations created by gas bubbling during B-CPAP. We feel that the recently FDA approved, Babi.plus system may provide a safe and effective alternative to the off-label HM B-CPAP systems that have been used over the last 40 years. Sponsored Research - None