Original Article
Journal of Perinatology (2005) 25, 453–458. doi:10.1038/sj.jp.7211325 Published online 28 April 2005
Work of Breathing During Nasal Continuous Positive Airway Pressure in Preterm Infants: A Comparison of Bubble vs Variable-Flow Devices
Statistical Consultant: Gerald Arnold, PhD MPH, Senior Statistician Research, Planning and Evaluation, American College of Physicians, Philadelphia, PA, USA.
Funded in part by SensorMedics, Inc.
Presented in part at the Society for Pediatric Research annual meeting in San Francisco, CA, May 2004.
Ellina Liptsen MD1, Zubair H Aghai MD2, Kee H Pyon PhD2, Judy G Saslow MD2, Tarek Nakhla MD2, Jennifer Long MD1, Andrew M Steele MD1, Robert H Habib PhD3 and Sherry E Courtney MD1
- 1Department of Pediatrics (E.L., J.L., A.M.S., S.E.C.), Schneider Children's Hospital, North Shore Long Island Jewish Health System, New Hyde Park, NY, USA
- 2Department of Pediatrics (Z.H.A., K.H.P., J.G.S., T.N.), Cooper Hospital University Medical Center, Camden, NJ, USA
- 3Department of Pediatrics (R.H.H.), Mercy Children's Hospital, Medical College of Ohio, Toledo, OH, USA
Correspondence: Sherry E. Courtney, MD, Division of Neonatology, Room 344, Schneider Children's Hospital, 269-01 76th Avenue, New Hyde Park, NY 11040, USA
Abstract
OBJECTIVE:
To compare work of breathing and breathing asynchrony during bubble nasal continuous positive airway pressure (NCPAP) vs variable-flow (VF)-NCPAP in premature infants.
STUDY DESIGN:
We studied 18 premature infants of birth weight <1500 g who required NCPAP for mild respiratory distress. Each infant was studied on bubble and VF-NCPAP at 8, 6, 4, and 0 cmH2O. Tidal volumes were obtained by calibrated respiratory inductance plethysmography. Esophageal pressure estimated intrapleural pressure. Inspiratory and resistive work of breathing were calculated from pressure–volume data. Breathing asynchrony was assessed with phase angle. The results at all NCPAP levels were referenced to VF-NCPAP values at 8 cmH2O.
RESULTS:
Provision of NCPAP with either device decreased inspiratory work of breathing, tidal volume, and minute ventilation relative to NCPAP of 0 cmH2O. Bubble NCPAP did not decrease resistive work of breathing relative to 0 cmH2O. Resistive work of breathing (p=0.01), respiratory rate (p<0.03), and phase angle (p=0.002) were all greater with bubble compared to VF-NCPAP.
CONCLUSION:
The more labored and asynchronous breathing seen with bubble NCPAP may lead to higher failure rates over the long term than with VF-NCPAP.
MORE ARTICLES LIKE THIS
These links to content published by NPG are automatically generated
RESEARCH
Work of breathing using high-flow nasal cannula in preterm infants
Journal of Perinatology Original Article
Early variable-flow nasal continuous positive airway pressure in infants ⩽1000 grams at birth
Journal of Perinatology Original Article
High flow nasal cannula versus nasal CPAP for neonatal respiratory disease: a retrospective study
Journal of Perinatology Original Article
