Related Experiment Video
Updated: Aug 18, 2026

Preoxygenation Techniques for Tracheal Intubation in Critically Ill Adults Utilizing Oxygen Mask and Noninvasive Ventilation
Published on: December 5, 2025
Work of breathing during nasal continuous positive airway pressure in preterm infants: a comparison of bubble vs
Ellina Liptsen1, Zubair H Aghai, Kee H Pyon
1Department of Pediatrics, Schneider Children's Hospital, North Shore Long Island Jewish Health System, New Hyde Park, NY 11040, USA.
Objective:
To compare work of breathing and breathing asynchrony during bubble nasal continuous positive airway pressure (NCPAP) vs variable-flow (VF)-NCPAP in premature infants.
Study Design:
We studied 18 premature infants of birth weight <1500 g who required NCPAP for mild respiratory distress. Each infant was studied on bubble and VF-NCPAP at 8, 6, 4, and 0 cm H2O. Tidal volumes were obtained by calibrated respiratory inductance plethysmography. Esophageal pressure estimated intrapleural pressure. Inspiratory and resistive work of breathing were calculated from pressure-volume data. Breathing asynchrony was assessed with phase angle. The results at all NCPAP levels were referenced to VF-NCPAP values at 8 cm H2O.
Results:
Provision of NCPAP with either device decreased inspiratory work of breathing, tidal volume, and minute ventilation relative to NCPAP of 0 cm H2O. Bubble NCPAP did not decrease resistive work of breathing relative to 0 cm H2O. Resistive work of breathing (p=0.01), respiratory rate (p<0.03), and phase angle (p=0.002) were all greater with bubble compared to VF-NCPAP.
Conclusion:
The more labored and asynchronous breathing seen with bubble NCPAP may lead to higher failure rates over the long term than with VF-NCPAP.
Related Concept Videos
Mechanical Ventilation III: Noninvasive Ventilation
Noninvasive Positive-Pressure Ventilation (NIPPV)
Mechanical Ventilation II: Invasive Ventilation
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Ventilatory Modes
There are three ventilatory modes: full support, partial support, and spontaneous. These are described below.
Full Support Modes
Full support modes include controlled mechanical ventilation, continuous mandatory...
Mechanical Ventilation I: Indication and Settings
Oxygen Delivering System I: Nasal Cannula and Face Mask
Nasal Cannula
A nasal cannula is a lightweight tube split at one end into two prongs and placed in the nostrils. It is typically used to deliver low to medium levels of oxygen.
Suggested flow rate: The suggested flow rate for a nasal cannula typically ranges between 1 and 6 L/min.
Oxygen percentage setting:...
Cardiopulmonary Resuscitation II: ACLS Airway Management
