Randomised In Vitro Study Investigating PEEP-Stability During Application of CPAP With Binasal Prongs and Face Masks

Area of Science:

• Neonatal respiratory support
• Medical device engineering
• Clinical trial methodology

Background:

• Continuous positive airway pressure (CPAP) is crucial for neonatal respiratory distress.
• Face masks and binasal prongs are common CPAP interfaces in neonatology.
• Assessing the stability and accuracy of CPAP delivery via different interfaces is essential for optimal patient care.

Purpose of the Study:

• To compare the CPAP stability and accuracy between face masks and binasal prongs in a simulated neonatal resuscitation scenario.
• To evaluate the impact of operator experience on CPAP delivery using these interfaces.

Main Methods:

• A randomized controlled in vitro study simulated a 1000-g preterm infant with respiratory distress.
• Twenty operators (with and without neonatology experience) applied CPAP aiming for 5 cmH2O using face masks or binasal prongs.
• The primary outcome was the minimum achieved CPAP at the Y-piece (PYmin); secondary outcomes included time to target CPAP and CPAP stability.

Main Results:

• Binasal prongs demonstrated more consistent maintenance of the target CPAP compared to face masks.
• Target CPAP was achieved significantly faster with face masks than with binasal prongs.
• Operator experience did not significantly affect the accuracy of CPAP delivery with either interface.

Conclusions:

• Binasal prongs facilitate more accurate CPAP maintenance than face masks in simulated neonatal settings, irrespective of operator experience.
• While binasal prongs offer superior CPAP stability, further clinical studies are needed to confirm their superiority over face masks.
• The findings highlight the importance of interface selection for effective neonatal respiratory support.