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Changes in lung volume and work of breathing: A comparison of two variable‐flow nasal continuous positive airway pressure devices in very low birth weight infants
Author(s) -
Courtney Sherry E.,
Aghai Zubair H.,
Saslow Judy G.,
Pyon Kee H.,
Habib Robert H.
Publication year - 2003
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.10327
Subject(s) - medicine , continuous positive airway pressure , work of breathing , anesthesia , tidal volume , lung volumes , pulmonary compliance , gestational age , ventilation (architecture) , respiratory distress , mechanical ventilation , respiratory minute volume , plethysmograph , respiratory rate , respiratory system , lung , heart rate , obstructive sleep apnea , pregnancy , blood pressure , mechanical engineering , biology , genetics , engineering
Variable flow nasal continuous positive airway pressure (VF‐NCPAP) recruits lung volume more effectively and reduces work of breathing (WOB) compared to constant‐flow NCPAP (CF‐NCPAP) in very low birth weight (VLBW) infants. Because different VF‐NCPAP devices have somewhat different flow patterns, whether different VF‐NCPAP devices function similarly is unknown. We compared two VF‐NCPAP devices: the Infant Flow™ (EME, Ltd.) and the Arabella® (Hamilton Medical) to assess whether lung volume recruitment and WOB were similar in VLBW infants requiring NCPAP. Eighteen infants <1,500 g were studied on both NCPAP devices applied in random order. All infants required NCPAP for mild respiratory distress. Calibrated DC‐coupled respiratory inductance plethysmography (RIP) was used to assess lung volume changes. NCPAP was first increased to 8 cmH 2 O to allow comparable recruitment in all infants, and then was slowly decreased to 6, 4, and 0 cmH 2 O, with data collection at each level. Mean birth weight (±SD) was 1,107 ± 218 g, gestational age was 27.9 ± 2.0 weeks, weight at study was 1,092 ± 222 g, and age at study was 4.6 ± 4.3 days. There were no differences in lung volume recruitment overall or at any NCPAP level ( P = 0.943). No differences were found in either inspiratory WOB ( P = 0.468) or in resistive WOB ( P = 0.610) between devices. Compliance, tidal volume, respiratory rate, and minute ventilation were also similar. Despite differences in flow characteristics between the two VF‐NCPAP devices we studied, lung volume recruitment and WOB were similar. Pediatr Pulmonol. 2003; 36:248–252. © 2003 Wiley‐Liss, Inc.