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https://www.readbyqxmd.com/read/28091776/nasal-masks-or-binasal-prongs-for-delivering-continuous-positive-airway-pressure-in-preterm-neonates-a-randomised-trial
#1
Aparna Chandrasekaran, Anu Thukral, M Jeeva Sankar, Ramesh Agarwal, Vinod K Paul, Ashok K Deorari
: The objective of this study was to compare the efficacy and safety of continuous positive airway pressure (CPAP) delivered using nasal masks with binasal prongs. We randomly allocated 72 neonates between 26 and 32 weeks gestation to receive bubble CPAP by either nasal mask (n = 37) or short binasal prongs (n = 35). Primary outcome was mean FiO2 requirement at 6, 12 and 24 h of CPAP initiation and the area under curve (AUC) of FiO2 against time during the first 24 h (FiO2 AUC0-24)...
January 13, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28073106/surfactant-need-by-gestation-for-very-preterm-babies-initiated-on-early-nasal-cpap-a-danish-observational-multicentre-study-of-6-628-infants-born-2000-2013
#2
Rikke Wiingreen, Gorm Greisen, Finn Ebbesen, Jesper Padkær Petersen, Gitte Zachariassen, Tine Brink Henriksen, Bo Mølholm Hansen
BACKGROUND: In recent years, early nasal continuous positive airway pressure (nCPAP) as respiratory support for preterm infants is being advocated as an alternative to prophylactic surfactant and treatment with mechanical ventilation. A number of infants treated with early nCPAP do not need treatment with surfactant, but few studies provide data on this. Since the 1990s, the first approach to respiratory support to preterm infants in Denmark has been early nCPAP combined with surfactant administration by the INSURE method by which the infant is intubated and surfactant administration is followed by rapid extubation to nCPAP if possible...
January 11, 2017: Neonatology
https://www.readbyqxmd.com/read/28054235/heated-humidified-high-flow-nasal-cannula-for-prevention-of-extubation-failure-in-preterm-infants
#3
Sasivimon Soonsawad, Buranee Swatesutipun, Anchalee Limrungsikul, Pracha Nuntnarumit
OBJECTIVES: To compare extubation failure rate between the heated humidified high-flow nasal cannula (HHHFNC) and continuous positive airway pressure (CPAP) groups. METHODS: Intubated infants with gestational age (GA) <32 wk, who were ready to extubate, were randomized to receive respiratory support with either CPAP or HHHFNC after extubation. In CPAP group, nasal mask CPAP with preset pressure and fraction of inspired oxygen (FiO2) equal to positive end-expiratory pressure (PEEP) and FiO2 of ventilator before extubation was applied...
January 5, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27986462/factors-contributing-to-unintentional-leak-during-cpap-treatment-a-systematic-review
#4
REVIEW
Marius Lebret, Jean-Benoit Martinot, Nathalie Arnol, Daniel Zerillo, Renaud Tamisier, Jean-Louis Pepin, Jean-Christian Borel
: Continuous positive airway pressure (CPAP) is the first-line treatment for moderate to severe obstructive sleep apnea syndrome (OSAS). Up to 25% of patients with OSAS discontinue CPAP treatment due to side effects. Unintentional leak and its associated annoying consequences are the most frequently reported adverse effects of CPAP. Successive technological improvements have not succeeded in addressing this issue. OBJECTIVES: A systematic review was conducted: (i) to assess the impact of different technological advances on unintentional leak and, (ii) to determine if any patient characteristics have already been identified as determinants of unintentional leak...
December 13, 2016: Chest
https://www.readbyqxmd.com/read/27977876/introducing-high-flow-nasal-cannula-to-the-neonatal-transport-environment
#5
Michael A Boyle, Arunava Dhar, Rajiv Chaudhary, Susan Kent, Samantha S O'Hare, Theodore Dassios, Susan Broster
Respiratory support using heated humidified high-flow nasal cannula (HFNC) therapy has become established practice over the past decade in neonatal intensive care units. HFNC therapy is delivered through small thin tapered cannulae that sit at the nasal aperture using oxygen, or blended oxygen and air, at flow rates greater than 1L/min(1, 2). Recently several studies have demonstrated that it can be safely used as a mode of respiratory support and that the positive end expiratory pressure generated is comparable to that delivered using continuous positive airway pressure (CPAP) (3-5)...
December 15, 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27938918/findings-of-the-maintenance-of-wakefulness-test-and-its-relationship-with-response-to-modafinil-therapy-for-residual-excessive-daytime-sleepiness-in-obstructive-sleep-apnea-patients-adequately-treated-with-nasal-continuous-positive-airway-pressure
#6
Yuichi Inoue, Masuo Miki, Toshiyuki Tabata
OBJECTIVE: We aimed to examine the relationship between subjective and objective sleepiness in obstructive sleep apnea syndrome (OSAS) patients with residual sleepiness, and to determine whether baseline objective sleepiness severity predicts the response to modafinil therapy. METHODS: Data were obtained from a randomized, placebo-controlled modafinil (200 mg/day) study in Japanese OSAS patients with residual sleepiness receiving nasal continuous positive pressure (n-CPAP) treatment...
November 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27938914/early-effects-of-continuous-positive-airway-pressure-in-a-rodent-model-of-allergic-rhinitis
#7
I Vilaseca, E Lehrer-Coriat, M Torres, F Aguilar, I Almendros, B M Martínez-Vidal, R Farré, J M Montserrat
BACKGROUND: Continuous positive airway pressure (CPAP) is the most commonly used treatment in obstructive sleep apnea. In a previous rat model study, we demonstrated that nasal CPAP induces early rhinitis expressed by nasal neutrophil extravasation. Here we hypothesized that nasal CPAP would worsen nasal inflammation on a previously inflamed mucosa. The objective of this study was to evaluate the early nasal CPAP effects of allergic rhinitis (AR) in a rodent model. METHODS: Twenty Sprague-Dawley rats were sensitized with intraperitoneal ovalbumin (OVA)...
November 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27899105/non-invasive-mechanical-ventilation-after-heart-surgery-in-children
#8
Sarah Fernández Lafever, Blanca Toledo, Miguel Leiva, Maite Padrón, Marina Balseiro, Angel Carrillo, Jesús López-Herce
BACKGROUND: The purpose of the study was to analyze the characteristics and evolution of non-invasive mechanical ventilation (NIV) in the postoperative period of heart surgery in children. METHODS: Retrospective observational study including all children requiring NIV after heart surgery in a single center pediatric intensive care unit (PICU) between 2001 and 2012. Demographic characteristics, ventilation parameters and outcomes were registered, comparing the first 6 years of the study with the last 6 years...
November 29, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27895847/efficacy-of-a-low-cost-bubble-cpap-system-in-treatment-of-respiratory-distress-in-a-neonatal-ward-in-malawi
#9
Kondwani Kawaza, Heather E Machen, Jocelyn Brown, Zondiwe Mwanza, Suzanne Iniguez, Al Gest, E O'Brian Smith, Maria Oden, Rebecca R Richards-Kortum, Elizabeth Molyneux
BACKGROUND: Respiratory failure is a leading cause of neonatal mortality in the developing world. Bubble continuous positive airway pressure (bCPAP) is a safe, effective intervention for infants with respiratory distress and is widely used in developed countries. Because of its high cost, bCPAP is not widely utilized in low-resource settings. We evaluated the performance of a new bCPAP system to treat severe respiratory distress in a low resource setting, comparing it to nasal oxygen therapy, the current standard of care...
September 2016: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/27887724/facial-deformations-during-nasal-continuous-positive-airway-pressure-therapy
#10
Andrew Sims, Anne Simmons, Mark Hoffman, Klaus Schindhelm
Obstructive Sleep Apnoea (OSA), characterised by repeated collapse of the pharyngeal airway during sleep, causes cessation of breathing followed by arousal, restoring normality. Continuous Positive Airway Pressure (CPAP) is a non-invasive, effective treatment for OSA where positive pressure is applied to the airway through a mask, maintaining patency. Nasal masks are commonly used, contacting the face across the upper lip, sides of the nose and the nasal bridge. Despite health benefits, therapy compliance is sub-optimal, often due to poor mask fit and discomfort...
December 8, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27878543/a-new-predictive-model-for-continuous-positive-airway-pressure-in-the-treatment-of-obstructive-sleep-apnea
#11
Matthew R Ebben, Mariya Narizhnaya, Ana C Krieger
BACKGROUND: Numerous mathematical formulas have been developed to determine continuous positive airway pressure (CPAP) without an in-laboratory titration study. Recent studies have shown that style of CPAP mask can affect the optimal pressure requirement. However, none of the current models take mask style into account. Therefore, the goal of this study was to develop new predictive models of CPAP that take into account the style of mask interface. METHODS: Data from 200 subjects with attended CPAP titrations during overnight polysomnograms using nasal masks and 132 subjects using oronasal masks were randomized and split into either a model development or validation group...
November 22, 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27871083/work-of-breathing-in-fixed-and-pressure-relief-continuous-positive-airway-pressure-c-flex%C3%A2-a-post-hoc-analysis
#12
Lukas Jerrentrup, Sebastian Canisius, Susanne Wilhelm, Karl Kesper, Thomas Ploch, Claus Vogelmeier, Timm Greulich, Heinrich F Becker
BACKGROUND: Expiratory pressure relief continuous positive airway pressure (pressure relief CPAP; C-Flex™) causes increases in inspiratory duty cycle and shortening of expiratory time. It has been suggested that these changes are caused by an increase in work of breathing. OBJECTIVES: We studied the effects of C-Flex on work of breathing and intrinsic positive end-expiratory pressure as compared to fixed CPAP. METHODS: Work of breathing was analyzed in 24 patients with obstructive sleep apnea during treatment with fixed CPAP and C-Flex with 3 different pressure relief settings in a randomized order during rapid-eye-movement (REM) and non-REM sleep...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27833866/long-term-outcomes-of-radiofrequency-ablation-of-the-inferior-turbinates
#13
Casey Means, Macario Camacho, Robson Capasso
Radiofrequency ablation of the inferior turbinates (RFAIT) is a minimally invasive surgical technique that reduces turbinate size and decreases nasal obstruction. Few studies have assessed long-term outcomes of this procedure using standardized, symptom-specific evaluation instruments. The primary aim of this study is to assess the long-term effectiveness of RFAIT using a standardized, symptom-specific evaluation instrument. An additional outcome evaluated is the effect of RFAIT on therapeutic CPAP pressures in centimetres of water pressure (cwp) and overall CPAP use...
December 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/27812636/gel-pillow-designed-specifically-for-obstructive-sleep-apnea-treatment-with-continuous-positive-airway-pressure
#14
Adriana Salvaggio, Anna Lo Bue, Serena Iacono Isidoro, Salvatore Romano, Oreste Marrone, Giuseppe Insalaco
Objective: To determine whether the use of a gel pillow with side cutouts designed to accommodate a continuous positive airway pressure (CPAP) mask and reduce head temperature improves the efficacy of and adherence to auto-CPAP therapy. Methods: Twenty-three consecutive CPAP-naïve patients with obstructive sleep apnea were enrolled in the study. Patients were given an auto-CPAP machine with an appropriate CPAP mask and were instructed to use CPAP for 15 nights...
September 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/27790540/a-randomized-trial-comparing-efficacy-of-bubble-and-ventilator-derived-nasal-cpap-in-very-low-birth-weight-neonates-with-respiratory-distress
#15
Sheetal Agarwal, Arti Maria, Mahesh K Roy, Ankit Verma
INTRODUCTION: Continuous Positive Airway Pressure (CPAP) has an established role in the care of Very Low Birth Weight (VLBW) babies with respiratory distress. Bubble CPAP (BCPAP) is a cheap alternative for countries where resources are limited. However, data comparing efficacy of BCPAP with conventional ventilator derived (VCPAP) is limited. AIM: To compare CPAP failure rates between BCPAP and VCPAP among VLBW, with moderate respiratory distress. Secondary objectives were to compare the rates of Intraventricular Haemorrhage (IVH), pulmonary air leaks and deaths between the two groups and determine the predictors of CPAP failure...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27787786/new-rule-based-algorithm-for-real-time-detecting-sleep-apnea-and-hypopnea-events-using-a-nasal-pressure-signal
#16
Hyoki Lee, Jonguk Park, Hojoong Kim, Kyoung-Joung Lee
We developed a rule-based algorithm for automatic real-time detection of sleep apnea and hypopnea events using a nasal pressure signal. Our basic premise was that the performance of our new algorithm using the nasal pressure signal would be comparable to that using other sensors as well as manual annotation labeled by a technician on polysomnography study. We investigated fifty patients with sleep apnea-hypopnea syndrome (age: 56.8 ± 10.5 years, apnea-hypopnea index (AHI): 36.2 ± 18.1/h) during full night PSG recordings at the sleep center...
December 2016: Journal of Medical Systems
https://www.readbyqxmd.com/read/27784404/arousal-intensity-is-a-distinct-pathophysiological-trait-in-obstructive-sleep-apnea
#17
Jason Amatoury, Ali Azarbarzin, Magdy Younes, Amy S Jordan, Andrew Wellman, Danny J Eckert
STUDY OBJECTIVES: Arousals from sleep vary in duration and intensity. Accordingly, the physiological consequences of different types of arousals may also vary. Factors that influence arousal intensity are only partly understood. This study aimed to determine if arousal intensity is mediated by the strength of the preceding respiratory stimulus, and investigate other factors mediating arousal intensity and its role on post-arousal ventilatory and pharyngeal muscle responses. METHODS: Data were acquired in 71 adults (17 controls, 54 obstructive sleep apnea patients) instrumented with polysomnography equipment plus genioglossus and tensor palatini electromyography (EMG), a nasal mask and pneumotachograph, and an epiglottic pressure sensor...
December 1, 2016: Sleep
https://www.readbyqxmd.com/read/27783410/survey-of-noninvasive-respiratory-support-practices-in-canadian-neonatal-intensive-care-units
#18
Amit Mukerji, Prakesh S Shah, Sandesh Shivananda, Wendy Yee, Brooke Read, John Minski, Ruben Alvaro, Christoph Fusch
AIM: To evaluate practice variation with respect to noninvasive respiratory support (NRS) use across Canadian neonatal intensive care units (NICUs). METHODS: A web-based survey was sent to all site investigators of the 30 level 3 NICUs participating in the Canadian Neonatal Network. The survey inquired about the use of five commonly described NRS modes. In addition, the presence and adherence to local guidelines were ascertained. Descriptive analyses were performed to identify variations in practice...
October 26, 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27720463/nasal-surgery-for-obstructive-sleep-apnea-syndrome
#19
REVIEW
Samuel A Mickelson
Obstructive sleep apnea is a common condition, primarily caused by narrowing of the nasal and pharyngeal airway. Treatment with continuous positive airway pressure (CPAP) is considered the first line of therapy, but long-term compliance is only about 40%, often because of nasal obstruction. Any nasal obstruction can worsen CPAP compliance. Treatment of the nasal obstruction with topical nasal steroid sprays or nasal dilators has been shown to improve sleep disordered breathing. Surgical treatment of nasal obstruction, has been shown to improve sleep disordered breathing, as well as CPAP requirement and compliance with CPAP...
December 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27711045/non-invasive-inhaled-nitric-oxide-in-the-treatment-of-hypoxemic-respiratory-failure-in-term-and-preterm-infants
#20
R Sahni, X Ameer, K Ohira-Kist, J-T Wung
OBJECTIVES: Inhaled nitric oxide (iNO) is effective in conjunction with tracheal intubation (TI) and mechanical ventilation (MV) for treating arterial pulmonary hypertension and hypoxemic respiratory failure (HRF) in near-term and term newborns. Non-invasive respiratory support with nasal continuous positive airway pressure (CPAP) is increasingly used to avoid morbidity associated with TI and MV, yet the effectiveness of iNO delivery via nasal CPAP remains unknown. To evaluate the effectiveness of iNO delivered via the bubble nasal CPAP system in term and preterm newborns with HRF...
January 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
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