2012 OPEN FORUM Abstracts
USE OF A NEW NASAL CANNULA TO DELIVER NASAL VENTILATION TO NICU PATIENTS.
Dolia Horton1, David Durand2; 1Respiratory Care Department, Childrens Hospital & Research Center Oakland, Oakland, CA; 2Department of Neonatology, Childrens Hospital & Research Center Oakland, Oakland, CA
Background: Non-invasive respiratory support is increasingly used for neonates, including extremely low weight infants. However, the efficacy of non-invasive support is frequently limited by the need for cumbersome headgear interfaces, which can cause nasal skin breakdown and significant leaks leading to inadequate support. Recently the Neotech RAM® cannula was introduced for use with both nasal continuous positive airway pressure (NCPAP) and nasal ventilation (NV). We report our experiences using the Neotech RAM® cannula to provide NV in newborn intensive care unit (NICU) patients weighing between 0.5 and 5.3 kg Method: NICU patients who met our standard criteria for NV were managed with the Neotech RAM® nasal cannula. The Servo I® and Crossvent 2i® ventilators were used to deliver NV. Response to NV was assessed according to (1) nasal skin injury, and (2) adequacy of support defined as needed for intubation or re-intubation. Results: Nine NICU patients weighing between 0.5 and 5.3 kg were managed in our NICU with the Neotech RAM® nasal cannula providing NV. The table below gives the indication for beginning NV as well as patient characteristics, rate of nasal injury, and rate of intubation or re-intubation. Conclusion: The Neotech RAM® cannula appears to be safe and effective at providing NV to a wide range of NICU infants with relatively low FIO2 requirements. It was our subjective assessment that these infants were more stable than similar infants who had previously received NV via another interface, presumably because of the excellent design and fit of the cannula to the nares. We now use this cannula as our primary interface for providing NV to our NICU infants. Sponsored Research - None