Article | Published:

Continuous positive airway pressure delivery during less invasive surfactant administration: a physiologic study

Journal of Perinatologyvolume 38pages271277 (2018) | Download Citation

Abstract

Objective

We sought to investigate the pressure delivery during less invasive surfactant administration, as we hypothesize that it might be reduced.

Study design

Physiologic in vitro study in a ventilation lab, using different pressure generators, levels, and leaks in a model of neonatal airways/lung mimicking mechanical characteristics of respiratory distress syndrome. Pressure was measured at the lung and verified in vivo measuring pharyngeal pressure in 19 neonates under same conditions. Data were analyzed using repeated measures-analysis of variance.

Results

Pressure delivery in vitro is significantly and variably reduced during minimally invasive surfactant administration: pressure loss is ≈99% and ≈10–97%, during mouth opening and closure, respectively. Pressure loss seems independent from the type of CPAP and interface. In vivo measurements showed similar pressure drops.

Conclusions

Pressure transmission during minimally invasive surfactant administration is significantly reduced or totally absent. Pressure drop occurs despite the increased airway resistances and the airflow limitation due to the tracheal catheterization, but is independent from the type of pressure generator and interface.

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Author information

Affiliations

  1. Division of Pediatrics, Neonatal Critical Care and Transportation, Medical Center “A.Béclère”, South Paris University Hospitals, APHP, Paris, France

    • Gilles Jourdain
    • , Marie De Tersant
    • , Valentina Dell’Orto
    • , Giorgio Conti
    •  & Daniele De Luca
  2. VentiLab, Institute of Anesthesiology and Critical Care, Catholic University of the Sacred Heart, Rome, Italy

    • Giorgio Conti
    •  & Daniele De Luca

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Conflict of interest

The authors declare that they have no conflict of interest.

Corresponding author

Correspondence to Daniele De Luca.

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DOI

https://doi.org/10.1038/s41372-017-0009-3