Noise levels during nCPAP are flow-dependent but not device-dependent

Area of Science:

• Neonatal Medicine
• Pediatric Critical Care
• Biomedical Engineering

Background:

• Nasal continuous positive airway pressure (nCPAP) improves outcomes for infants with respiratory distress syndrome.
• Noise generation from nCPAP devices is a potential concern for infant hearing and development.
• Understanding nCPAP noise levels is critical for optimizing neonatal intensive care unit (NICU) environments.

Purpose of the Study:

• To quantify the noise levels produced by various nCPAP delivery systems.
• To assess the relationship between nCPAP settings (flow, pressure) and generated noise.
• To evaluate the potential risks of noise exposure to premature infants.

Main Methods:

• Noise levels were measured in the oral cavity of infants using a microphonic probe and flexible capillary tube.
• Measurements were conducted on infants in neonatal and pediatric critical care units.
• Multiple nCPAP drivers and interfaces were tested.

Main Results:

• A total of 27 measurements were performed on eight infants.
• The mean noise level was 88.6 dB (SD 18.8 dB).
• Noise levels correlated significantly with flow (p<0.01) but not pressure; 67% of measurements exceeded 90 dB.

Conclusions:

• nCPAP is a valuable tool for neonatal respiratory support, potentially avoiding mechanical ventilation.
• Current nCPAP devices generate significant noise, frequently surpassing occupational safety limits for adults.
• There is a critical need for the development of novel nCPAP devices designed to minimize harmful noise exposure in premature infants.