The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts


Mitchell Goldstein, T. A. Merritt, Carter Tong, Michael Terry, Elba Fayard, Richard Peverini; Neonatology, Loma Linda University ChildrenÂ’s Hospital, Loma Linda, CA

Background: Nasal Continuous Airway Pressure (NCPAP) has long been used to provide ventilatory support in the NICU. The form of CPAP selected may be critically important in the management of neonatal respiratory distress. Studies have suggested that vibratory impulses present in bubble CPAP may enhance the effectiveness of this mode of ventilation. However, the frequencies may differ between devices and may also differ on the basis of changes in the level of CPAP provided as well as flow and compliance changes in the lung as well. We asked if the Babi.Plus, a novel CPAP device, produced vibratory frequencies that may be in the useful range for neonatal ventilation. Methods: A Babi.Plus nasal CPAP device (A Plus Medical) was interfaced with a test lung of varying compliance. Flow was varied from 2 to 8 LPM, CPAP was varied from 4 to 8 cm H2O, and compliance was varied from 0.2 to 1.0. Pressure and flow measures were obtained from the side port of the test lung using a Fleisch pneumotachograph interfaced with Validyne flow and pressure sensors with sampling at 1000 Hz to Easy Sense for the IBM PC. FFT analysis was performed in Sigview V2.4.0. Frequencies over 50 Hz were excluded. Relational analysis and graphing was performed with Statistica 10 (Statsoft). Results: Primary frequencies were identified in waveform analysis that we within the index range. Conclusions: Waveforms inherent in bubble CPAP may improve CPAP tolerance and effectiveness through propagation of a vibratory waveform. These vary according to device, flow, CPAP level and lung compliance. The Babi.Plus CPAP device may provide useful vibration that can improve the efficiency of CPAP. Further clinical correlation is required to define the useful range. Sponsored Research - None