Abstract
Objective
To measure tidal volume delivery during nasal intermittent positive pressure ventilation with two nasal interfaces: infant cannula and nasal prongs.
Study design
A single-center crossover study of neonates with mild respiratory distress. Fifteen preterm neonates were randomized to initial interface of infant cannula or nasal prongs and monitored on a sequence of pressure settings first on the initial interface, then repeated on the alternate interface. We compared relative tidal volumes between the two interfaces with two-way repeated measures ANOVA during three breath types: synchronized (I), patient effort without ventilator breaths (II), and ventilator breaths without patient effort (III). Clinical trial #NCT04326270.
Results
Type III breaths delivered no significant tidal volume. No significant difference was measured in relative tidal volume delivery between the interfaces when breath types were matched.
Conclusions
Nasal intermittent positive pressure ventilation delivers neither clinically nor statistically significant tidal volume with either infant cannula or nasal prongs.
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Data availability
The data from the results of this study are available from the corresponding author on reasonable request.
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Acknowledgements
The authors would like to thank Arkansas Children’s Hospital and the University of Arkansas for Medical Sciences for the provision of a supportive environment in which to conduct research. We would also like to thank the nursing and respiratory therapy staff for their willingness to assist with instrumentation and other practical matters when needed. We thank Mr. Norm Comtois for his invaluable assistance with data analysis. Finally, we thank the families who allowed us the privilege of enlisting their babies in our pursual of improved practices in neonatal critical care.
Funding
This research study was funded by a Postdoctoral Fellowship Grant Award from Arkansas Children’s Research Institute.
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ALL, DNM, MDW, JB, CS, and SEC contributed to the conception and design of this study. ALL, DNM, and SEC consented and enrolled study patients and collected data from the trials. ALL, DNM, BS, MDW, JB, CS, and SEC contributed to data analysis and interpretation. The manuscript was composed by ALL, with critical revisions by DNM, BS, MDW, JB, CS, and SEC.
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JB, CS have secured patents for original inventions of technology for neural control of mechanical ventilation. These patents are designated to the academic institutions where the inventions were created, and the license for the patents is owned by Maquet Critical Care®. Commercial use of this technology may result in future financial gain to JB and CS via royalty payments. Neurovent Research Inc.® (NVR) is a research and development company owned by JB and CS which manufactures equipment and catheters for research studies, and there is a consultant contract between NVR and Maquet Critical Care®. ALL, DNM, BS, and SEC have no disclosures.
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Lynch, A.L., Matlock, D.N., Akmyradov, C. et al. Tidal volume delivery during nasal intermittent positive pressure ventilation: infant cannula vs. nasal continuous positive airway pressure prongs. J Perinatol 44, 244–249 (2024). https://doi.org/10.1038/s41372-023-01846-7
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DOI: https://doi.org/10.1038/s41372-023-01846-7