Volume Oscillations Delivered to a Lung Model Using 4 Different Bubble CPAP Systems.

Area of Science:

• Neonatal respiratory support
• Infant lung mechanics

Background:

• Bubble continuous positive airway pressure (CPAP) uses gas oscillations to improve ventilation and lung recruitment in premature infants.
• This study investigated if different bubble CPAP systems yield varying magnitudes of lung volume oscillations (ΔV).

Purpose of the Study:

• To compare the magnitude of lung volume oscillations (ΔV) generated by different bubble CPAP systems in a preterm neonatal lung model.
• To determine if system configuration impacts ventilatory effects.

Main Methods:

• An infant nasal airway model connected to a Silastic test lung within a plethysmograph was used.
• Bubble CPAP systems were applied at 6 cm H2O, and ΔV was calculated from plethysmograph pressure measurements.

Main Results:

• The Fisher & Paykel Healthcare bubble CPAP system generated significantly greater ΔV than other systems across tested bias flows (P < .05).
• This system, along with Babi.Plus, produced ΔV at lower frequencies compared to alternatives.
• ΔV increased with bias flow > 4 L/min for Fisher & Paykel, Airways Development, and homemade systems, but decreased with Babi.Plus.

Conclusions:

• Bubble CPAP systems can achieve measurable ventilation effects in an infant lung model.
• Observed ΔV differences are likely due to variations in circuit/nasal prong and bubbler configurations, as well as oscillation frequency.
• Further research in spontaneously breathing infants is necessary to confirm clinical benefits.