2012 OPEN FORUM Abstracts
A BENCH EVALUATION OF TIDAL VOLUME DELIVERY THROUGH VARIOUS NASAL INTERFACES USING A NEONATAL AIRWAY AND INFANT MODEL.
Kevin Crezee, Rick Carter, Jeff Hoydu; Respiratory Care, Primary Childrens Medical Center, Salt lake City, UT
Background: A common method of support in the NICU is Nasal CPAP (NCPAP) and Nasal Intermittent Mandatory Ventilation (NIMV). The aim of this study was to test various devices and interfaces for their ability to deliver Tidal Volume (Vt) and Minute Ventilation (VE). Method: A Evita XL and Babylog ventilator was prepared. 3 nasal devices were used for each model. The Neonatal Airway (NA): 0 Hudson (Research Triangle Park, North Carolina), Infant Fisher & Paykel (F&P) HFNC (Auckland, New Zealand) and Preemie Ram (Valencia, California). The Infant Model (IM): 3 Hudson, Pediatric F&P HFNC and Infant Ram. The NA is a 700 gram preemie. The IM is a 2-3kg infant. Prongs were attached to models to get occlusive seal. Model was attached to TSI certifier FA Plus (Shoreview, Minnesota) and infant IMTMedical Smartlung (ag, Switzerland). Smartlung set resistance 5 mbar/L/s and compliance 5ml/mbar. Evita XL settings: Rate 20, It .4, PIP/PEEP 14/6 and PIP/PEEP 20/8. Babylog settings where same as Evita except flows of 8, 10 and 12 were measured as well. Results: NA: PIP/PEEP 14/6cmH2O: Average Vt was 8.6ml. Largest Vt measured was 15ml. Smallest Vt measured was 5ml. Average VE measured was .160L/m. Largest VE was .296L/m. Smallest VE was .88L/m. NA: PIP/PEEP 20/8cmH2O: Average Vt was 11.3ml. Largest Vt was 20ml. Smallest Vt was 6ml. Average VE was .220L/m. Largest VE was .399L/m. Smallest VE was .103L/m. IM: PIP/PEEP 14/6cmH2O: Average Vt was 15.1ml. Largest Vt was 18ml. Smallest Vt was 12ml. Average VE was . 297L/m. Largest VE was .368L/m. Smallest VE was .236L/m. IM: PIP/PEEP 20/8cmH2O: Average Vt was 22.1ml. Largest Vt was 31ml. Smallest Vt was 16ml. Average VE was .435L/m. Largest VE was .450L/min. Smallest VE was .305L/m. Conclusion: The largest Vt measured in both models was with the Hudson prongs and Evita XL. The Infant RAM cannula achieved Vt within 15% of maximum Vt. No direct relationship was established between increasing flows on the Babylog and increased Vt. Comparison minimum to maximum: Vt increased an average of 79% in NA and 42% in IM. VE increased 102% in NA and 47% in IM. The difference in Vt was directly related to device and type of interface. Sponsored Research - None