Comparison of nasal intermittent positive pressure ventilation and bubble CPAP with an in‐line high‐frequency interrupter in a premature infant lung model

• Published in: Pediatric pulmonology 2022-10, Vol.57 (10), p.2356-2362
• Main Authors: Rub, David M., Sivieri, Emidio M., Abbasi, Soraya, Sieberlich, William, Eichenwald, Eric C.
• Format: Article
• Language: English
• Subjects: Continuous positive airway pressure; infant; neonatal pulmonary medicine; noninvasive ventilation; Premature babies; Premature birth; pulmonary function; respiratory technology
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.26039

Introduction Noninvasive ventilation has become a staple in the care of premature infants. However, failure rates continue to be high in this population. Modifications to noninvasive support, such as nasal intermittent positive pressure ventilation (NIPPV), are used clinically to reduce such failure. Previous in vitro studies have shown improved CO2 clearance when superimposing high‐frequency oscillations onto bubble continuous positive airway pressure (BCPAP). Objective To compare the CO2 clearance of NIPPV to BCPAP with an in‐line high‐frequency interrupter (HFI) in a premature infant lung model. Methods A premature infant lung model was connected to either a Dräger VN500 for delivery of NIPPV or a BCPAP device with superimposed high‐frequency oscillations generated by an in‐line HFI. Change in end‐tidal CO2 (ETCO2) and mean airway pressure at the simulated trachea were measured and compared for both noninvasive modalities. Results Superimposing HF oscillations onto BCPAP with an in‐line HFI resulted in improved CO2 clearance relative to BCPAP alone for all tested oscillation frequencies at all CPAP levels (p