Ventilation with CPAP

Article Outline

• Copyright

Continuous positive airway pressure (CPAP) is being used more frequently as the initial therapy for preterm infants with respiratory distress syndrome (RDS). Failures occur because of the need to treat progressive RDS with surfactant and because of apnea and inadequate breathing effort. An advancement in conventional ventilation for infants with RDS has been the ability to synchronize the mechanical ventilatory cycle with the infant’s inspiratory effort. A number of reports suggest that a mechanical ventilatory cycle can be superimposed on nasal CPAP with the goal to assist spontaneous ventilation and to avoid intubation and traditional mechanical ventilation.

Kugelman et al report a single site trial of CPAP in comparison to CPAP plus nasal mechanical ventilation for infants with RDS. The supplemental mechanical ventilation decreased the number of infants requiring intubation and decreased bronchopulmonary dysplasia. A weakness of the study was the lack of validation of the effectiveness of synchronization of the ventilatory cycles with spontaneous ventilation. This report is an example of the foment in the field of neonatal ventilation to develop new devices and strategies to improve outcomes.

• 
  • View Large Image
  • Download to PowerPoint