Perinatology.  2019 Jun;30(2):83-92. 10.14734/PN.2019.30.2.83.

Feasibility and Functional Evaluation of Noninvasive Ventilation Capable Equipment from the Delivery Room to Neonatal Intensive Care Unit: A Bench Study

Affiliations
  • 1Department of Pediatrics, Gachon University College of Medicine, Incheon, Korea. sondw@gilhospital.com
  • 2Department of Obstetrics and Gynecology, Gachon University College of Medicine, Incheon, Korea.

Abstract


OBJECTIVE
The use of noninvasive ventilation (NIV) for newborns requiring respiratory support in delivery room (DR) is recommended. However, the details related to such use are not well established. A bench investigation on the performance of available NIV equipment was conducted.
METHODS
Two T-piece resuscitators (TPRs) and three ventilators were tested with a Neonatal Lung Simulator which is capable of recording the pressure, flow, and volume. We measured the pressurization and delivered volume (DV) of nasal continuous positive airway pressure (nCPAP), bubble CPAP (bCPAP)/nasal high-frequency ventilation (nHFV), and synchronized nasal intermittent positive pressure ventilation (SNIPPV) in apneic and breathing models. Temperature and absolute humidity (AH) at the Y-piece were checked for 10 minutes in each setting while the Y-piece on an open bassinet or in a preheated incubator.
RESULTS
The pressurization was well achieved with every combination except for TPRs on nCPAP. DV was well provided using bCPAP/nHFV and SNIPPV in the breathing model. With bCPAP, DV decreased significantly in apneic model. On the bassinet, temperature and AH dropped to ambient temperature and approximately 25 mgH₂O/L within 4 minutes, respectively. In the incubator, temperature and AH on all pre-humidified machines were maintained above 34℃ and 30 mgH₂O/L for 5 minutes, respectively. Those without pre-humidification were below 30℃ and less than 20 mgH₂O/L, respectively.
CONCLUSION
Other combination of device/equipment than TPR tested seemed more feasible for nCPAP. The use of equipment with backup ventilation and heated-humidified gas in preheated incubators would be more appropriate NIV for premature infants in DR and during transport.

Keyword

Continuous positive airway pressure; Equipment design; Humidity; Newborn; Transportation

MeSH Terms

Continuous Positive Airway Pressure
Delivery Rooms*
Equipment Design
High-Frequency Ventilation
Humans
Humidity
Incubators
Infant, Newborn
Infant, Premature
Intensive Care, Neonatal*
Intermittent Positive-Pressure Ventilation
Lung
Noninvasive Ventilation*
Respiration
Transportation
Ventilation
Ventilators, Mechanical
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