Use of the RAM Cannula with Early Bubble Continuous Positive Airway Pressure Requires Higher Pressures: Clinical and In vitro Evaluations
| Autor: | Colleen C. Claassen, Marya L. Strand, Noah H. Hillman, Howard L. Williams |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Neonatal intensive care unit medicine.medical_treatment 03 medical and health sciences 0302 clinical medicine Intensive Care Units Neonatal Intubation Intratracheal Pressure medicine Cannula Humans Infant Very Low Birth Weight Intubation Treatment Failure Continuous positive airway pressure Retrospective Studies Mechanical ventilation Respiratory Distress Syndrome Newborn 030219 obstetrics & reproductive medicine Continuous Positive Airway Pressure business.industry Delivery room Infant Newborn Obstetrics and Gynecology medicine.disease Bronchopulmonary dysplasia Pneumothorax Anesthesia Pediatrics Perinatology and Child Health Linear Models Female business Infant Premature |
| Zdroj: | American Journal of Perinatology. 38:1167-1173 |
| ISSN: | 1098-8785 0735-1631 |
| Popis: | Objective Early bubble continuous positive airway pressure (bCPAP) in the delivery room (DR) reduces early intubation, mechanical ventilation, and bronchopulmonary dysplasia. The RAM cannula, adopted for ease of patient care, is a high resistance nasal interface that, when used with bCPAP, only transmits a portion of set pressures and attenuates the bubble effects. This study aimed to review early bCPAP pressures and bCPAP failure with the RAM cannula interface over a 6-year period. Study Design Retrospective, single-center study of infants delivered Results The percentage of infants intubated in the DR decreased over time (59 to 42%), while the average bCPAP pressure increased from 5.3 to 6.8 cmH2O. A total of 355 infants (48%) were admitted to the neonatal intensive care unit (NICU) from the DR on BCPAP. The failure rate for bCPAP in NICU within 72 hours decreased from 45 to 24% as the maximum CPAP increased from 5.8 to 7.6 cmH2O. Pneumothorax rates did not change. CPAP pressure transmission decreased with all sizes of the RAM cannula. Conclusion When utilizing the RAM cannula for bCPAP, higher CPAP levels were associated with decreases in DR intubations and CPAP failure within the first 72 hours. If clinicians choose to use the RAM cannula for bCPAP, they will need higher set pressures to achieve lung inflation and the beneficial oscillatory effect will be diminished. Key Points |
| Databáze: | OpenAIRE |
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