Changes in lung volume and work of breathing: A comparison of two variable‐flow nasal continuous positive airway pressure devices in very low birth weight infants

Publisher Website
Google Scholar
Abstract
Variable flow nasal continuous positive airway pressure (VF‐NCPAP) recruits lung volume more effectively and reduces work of breathing (WOB) compared to constant‐flow NCPAP (CF‐NCPAP) in very low birth weight (VLBW) infants. Because different VF‐NCPAP devices have somewhat different flow patterns, whether different VF‐NCPAP devices function similarly is unknown. We compared two VF‐NCPAP devices: the Infant Flow™ (EME, Ltd.) and the Arabella® (Hamilton Medical) to assess whether lung volume recruitment and WOB were similar in VLBW infants requiring NCPAP. Eighteen infants 2O to allow comparable recruitment in all infants, and then was slowly decreased to 6, 4, and 0 cmH2O, with data collection at each level. Mean birth weight (±SD) was 1,107 ± 218 g, gestational age was 27.9 ± 2.0 weeks, weight at study was 1,092 ± 222 g, and age at study was 4.6 ± 4.3 days. There were no differences in lung volume recruitment overall or at any NCPAP level (P = 0.943). No differences were found in either inspiratory WOB (P = 0.468) or in resistive WOB (P = 0.610) between devices. Compliance, tidal volume, respiratory rate, and minute ventilation were also similar. Despite differences in flow characteristics between the two VF‐NCPAP devices we studied, lung volume recruitment and WOB were similar. Pediatr Pulmonol. 2003; 36:248–252.