Premium
Synchronized nasal intermittent positive pressure ventilation (SNIPPV) decreases work of breathing (WOB) in premature infants with respiratory distress syndrome (RDS) compared to nasal continuous positive airway pressure (NCPAP)
Author(s) -
Aghai Zubair H.,
Saslow Judy G.,
Nakhla Tarek,
Milcarek Barry,
Hart James,
LawryshPlunkett Robyn,
Stahl Gary,
Habib Robert H.,
Pyon Kee H.
Publication year - 2006
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.20461
Subject(s) - medicine , tidal volume , continuous positive airway pressure , anesthesia , respiratory distress , work of breathing , ventilation (architecture) , plethysmograph , respiratory system , respiratory rate , mechanical ventilation , respiratory minute volume , heart rate , blood pressure , obstructive sleep apnea , mechanical engineering , engineering
Synchronized nasal intermittent positive pressure ventilation (SNIPPV) is non‐invasive respiratory support that delivers ventilator breaths via the nasal prongs. We hypothesized that SNIPPV is more effective than nasal continuous positive airway pressure (NCPAP) in premature neonates due to decreased work of breathing (WOB). Fifteen infants (BW: 1,367 ± 325 g, GA: 29.5 ± 2.4 weeks) were studied on (a) NCPAP at 5 cmH 2 O (NCPAP5) and (b) three increasing SNIPPV settings achieved by NCPAP5 with additional delivered peak inspiratory pressures (PIP) of 10, 12, and 14 cmH 2 O. Tidal volumes and transpulmonary pressures were estimated via calibrated respiratory inductance plethysmography (RIP) and esophageal pressures, respectively. Inspiratory (WOB insp ), resistive (RWOB), and elastic (WOB E ) components of WOB were calculated using standard methods. Compared to NCPAP5, (a) WOB insp and RWOB were significantly lower with SNIPPV12, and were similarly lower with SNIPPV14 and (b) WOB E was significantly lower only with SNIPPV14. WOB components did not differ significantly for the three SNIPPV settings. Tidal volume, respiratory rate (RR), minute ventilation, compliance, and phase angle were similar for all four measurements. In conclusion, compared to NCPAP, the addition of ventilator‐delivered PIP during SNIPPV decreases WOB in premature infants. Pediatr Pulmonol. © 2006 Wiley‐Liss, Inc.