An in‐line high frequency flow interrupter applied to nasal CPAP: Improved carbon dioxide clearance in a premature infant lung model

Background Noninvasive respiratory support continues to have high failure rates in small preterm infants. We previously demonstrated significantly improved in vitro CO2 washout by applying oscillations to a high flow nasal cannula system. Objective To develop a high frequency flow interrupter that c...

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Bibliographic Details
Published in:Pediatric pulmonology 2019-12, Vol.54 (12), p.1974-1981
Main Authors: Sivieri, Emidio M., Eichenwald, Eric C., Rub, David M., Abbasi, Soraya
Format: Article
Language:English
Subjects:
bubble CPAP
Cannula
Carbon dioxide
Carbon Dioxide - analysis
Catheters
CO2 clearance
Continuous positive airway pressure
Continuous Positive Airway Pressure - instrumentation
high frequency oscillation
High-Frequency Ventilation
Humans
Infant
infant lung model
Infant, Newborn
Infant, Premature
Lung
Models, Biological
noninvasive ventilation
Nose
premature infant
Pressure
Respiratory therapy
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Summary:Background Noninvasive respiratory support continues to have high failure rates in small preterm infants. We previously demonstrated significantly improved in vitro CO2 washout by applying oscillations to a high flow nasal cannula system. Objective To develop a high frequency flow interrupter that could be applied to commonly used nasal continuous positive airway pressure (NCPAP) devices and to determine the effect of oscillations on end‐tidal carbon dioxide (EtCO2) levels in an infant lung model. Design/Methods NCPAP was applied to a premature infant lung simulator using either bubble (BCPAP) or variable‐flow (VCPAP) CPAP. Supply gas was interrupted with a solenoid pinch valve. EtCO2 was measured before and during oscillation and repeated at 4, 6, 8, 10, and 12 Hz oscillation and CPAP pressures of 4, 6, and 8 cm H 2O. Results BCPAP and VCPAP EtCO2 levels decreased with oscillation (P 
ISSN:8755-6863
1099-0496
DOI:10.1002/ppul.24505