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Published in: BMC Pulmonary Medicine 1/2018

Open Access 01-12-2018 | Research article

Comparative bench study evaluation of different infant interfaces for non-invasive ventilation

Authors: Giorgio Conti, Giorgia Spinazzola, Cesare Gregoretti, Giuliano Ferrone, Andrea Cortegiani, Olimpia Festa, Marco Piastra, Luca Tortorolo, Roberta Costa

Published in: BMC Pulmonary Medicine | Issue 1/2018

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Abstract

Background

To compare, in terms of patient-ventilator interaction and performance, a new nasal mask (Respireo, AirLiquide, FR) with the Endotracheal tube (ET) and a commonly used nasal mask (FPM, Fisher and Paykel, NZ) for delivering Pressure Support Ventilation (PSV) in an infant model of Acute Respiratory Failure (ARF).

Methods

An active test lung (ASL 5000) connected to an infant mannequin through 3 different interfaces (Respireo, ET and FPM), was ventilated with a standard ICU ventilator set in PSV. The test lung was set to simulate a 5.5 kg infant with ARF, breathing at 50 and 60 breaths/min). Non-invasive ventilation (NIV) mode was not used and the leaks were nearly zero.

Results

The ET showed the shortest inspiratory trigger delay and pressurization time compared to FPM and Respireo (p < 0.01). At each respiratory rate tested, the FPM showed the shortest Expiratory trigger delay compared to ET and Respireo (p < 0.01). The Respireo presented a lower value of Inspiratory pressure–time product and trigger pressure drop than ET (p < 0.01), while no significant difference was found in terms of pressure-time product at 300 and 500 ms. During all tests, compared with the FPM, ET showed a significantly higher tidal volume (VT) delivered (p < 0.01), while Respireo showed a trend toward an increase of tidal volume delivered compared with FPM.

Conclusions

The ET showed a better patient-ventilator interaction and performance compared to both the nasal masks. Despite the higher internal volume, Respireo showed a trend toward an increase of the delivered tidal volume; globally, its efficiency in terms of patient-ventilator interaction was comparable to the FPM, which is the infant NIV mask characterized by the smaller internal volume among the (few) models on the market.
Literature
1.
go back to reference Yanez LJ, Yunge M, Emilfork M, Lapadula M, Alcantara A, Fernandez C, Lozano J, Contreras M, Conto L, Arevalo C, Gayan A, Hernandez F, Pedraza M, Feddersen M, Bejares M, Morales M, Mallea F, Glasinovic M, Cavada G. A prospective, randomized, controlled trial of noninvasive ventilation in pediatric acute respiratory failure. Pediatr Crit Care Med. 2008;9:484–9.CrossRefPubMed Yanez LJ, Yunge M, Emilfork M, Lapadula M, Alcantara A, Fernandez C, Lozano J, Contreras M, Conto L, Arevalo C, Gayan A, Hernandez F, Pedraza M, Feddersen M, Bejares M, Morales M, Mallea F, Glasinovic M, Cavada G. A prospective, randomized, controlled trial of noninvasive ventilation in pediatric acute respiratory failure. Pediatr Crit Care Med. 2008;9:484–9.CrossRefPubMed
2.
go back to reference Gregoretti C, Pisani L, Cortegiani A, Ranieri VM. Noninvasive ventilation in critically ill patients. Crit Care Clin. 2015;31:435–57.CrossRefPubMed Gregoretti C, Pisani L, Cortegiani A, Ranieri VM. Noninvasive ventilation in critically ill patients. Crit Care Clin. 2015;31:435–57.CrossRefPubMed
3.
go back to reference Bimkrant DJ, Pope JF, Eiben RM. Topical review: pediatric noninvasive nasal ventilation. J Child Neurol. 2016;12:231–6.CrossRef Bimkrant DJ, Pope JF, Eiben RM. Topical review: pediatric noninvasive nasal ventilation. J Child Neurol. 2016;12:231–6.CrossRef
4.
go back to reference Fortenberry JD, Del Toro J, Jefferson LS, Evey L, Haase D. Management of Pediatric Acute Hypoxemic Respiratory Insufficiency with Bilevel Positive Pressure (BiPAP) nasal mask ventilation. Chest. 1995;108:1059–64.CrossRefPubMed Fortenberry JD, Del Toro J, Jefferson LS, Evey L, Haase D. Management of Pediatric Acute Hypoxemic Respiratory Insufficiency with Bilevel Positive Pressure (BiPAP) nasal mask ventilation. Chest. 1995;108:1059–64.CrossRefPubMed
5.
go back to reference Padman R, Lawless S, Nessen Von S. Use of BiPAP by nasal mask in the treatment of respiratory insufficiency in pediatric patients: preliminary investigation. Pediatr Pulmonol. 1994;17:119–23.CrossRefPubMed Padman R, Lawless S, Nessen Von S. Use of BiPAP by nasal mask in the treatment of respiratory insufficiency in pediatric patients: preliminary investigation. Pediatr Pulmonol. 1994;17:119–23.CrossRefPubMed
6.
go back to reference Conti G, Gregoretti C, Spinazzola G, Festa O, Ferrone G, Cipriani F, Rossi M, Piastra M, Costa R. Influence of different interfaces on synchrony during pressure support ventilation in a pediatric setting: a bench study. Respir Care. 2015;60:498–507.CrossRefPubMed Conti G, Gregoretti C, Spinazzola G, Festa O, Ferrone G, Cipriani F, Rossi M, Piastra M, Costa R. Influence of different interfaces on synchrony during pressure support ventilation in a pediatric setting: a bench study. Respir Care. 2015;60:498–507.CrossRefPubMed
7.
go back to reference Teague WG. Noninvasive ventilation in the pediatric intensive care unit for children with acute respiratory failure. Pediatr Pulmonol. 2003;35:418–26.CrossRefPubMed Teague WG. Noninvasive ventilation in the pediatric intensive care unit for children with acute respiratory failure. Pediatr Pulmonol. 2003;35:418–26.CrossRefPubMed
8.
go back to reference Bordessoule A, Emeriaud G, Morneau S, Jouvet P, Beck J. Neurally adjusted ventilatory assist improves patient-ventilator interaction in infants as compared with conventional ventilation. Pediatr Res. 2012;72:194–202.CrossRefPubMed Bordessoule A, Emeriaud G, Morneau S, Jouvet P, Beck J. Neurally adjusted ventilatory assist improves patient-ventilator interaction in infants as compared with conventional ventilation. Pediatr Res. 2012;72:194–202.CrossRefPubMed
9.
go back to reference Conti G, Costa R. Technological development in mechanical ventilation. Curr Opin Crit Care. 2010;16:26–33.CrossRefPubMed Conti G, Costa R. Technological development in mechanical ventilation. Curr Opin Crit Care. 2010;16:26–33.CrossRefPubMed
10.
go back to reference Longhini F, Ferrero F, De Luca D, Cosi G, Alemani M, Colombo D, Cammarota G, Berni P, Conti G, Bona G, Corte Della F, Navalesi P. Neurally adjusted ventilatory assist in preterm neonates with acute respiratory failure. Neonatology. 2015;107:60–7.CrossRefPubMed Longhini F, Ferrero F, De Luca D, Cosi G, Alemani M, Colombo D, Cammarota G, Berni P, Conti G, Bona G, Corte Della F, Navalesi P. Neurally adjusted ventilatory assist in preterm neonates with acute respiratory failure. Neonatology. 2015;107:60–7.CrossRefPubMed
11.
go back to reference Costa R, Navalesi P, Spinazzola G, Ferrone G, Pellegrini A, Cavaliere F, Proietti R, Antonelli M, Conti G. Influence of ventilator settings on patient-ventilator synchrony during pressure support ventilation with different interfaces. Intensive Care Med. 2010;36:1363–70.CrossRefPubMed Costa R, Navalesi P, Spinazzola G, Ferrone G, Pellegrini A, Cavaliere F, Proietti R, Antonelli M, Conti G. Influence of ventilator settings on patient-ventilator synchrony during pressure support ventilation with different interfaces. Intensive Care Med. 2010;36:1363–70.CrossRefPubMed
12.
go back to reference Shott SR, Myer CM, Willis R, Cotton RT. Nasal obstruction in the neonate. Rhinology. 1989;27:91–6.PubMed Shott SR, Myer CM, Willis R, Cotton RT. Nasal obstruction in the neonate. Rhinology. 1989;27:91–6.PubMed
13.
go back to reference De Luca D, Costa R, Visconti F, Piastra M, Conti G. Oscillation transmission and volume delivery during face mask-delivered HFOV in infants: bench and in vivo study. Pediatr Pulmonol. 2016;51:705–12.CrossRefPubMed De Luca D, Costa R, Visconti F, Piastra M, Conti G. Oscillation transmission and volume delivery during face mask-delivered HFOV in infants: bench and in vivo study. Pediatr Pulmonol. 2016;51:705–12.CrossRefPubMed
14.
go back to reference Howells R, Madar J. Newborn resuscitation training--which manikin. Resuscitation. 2002;54:175–81.CrossRefPubMed Howells R, Madar J. Newborn resuscitation training--which manikin. Resuscitation. 2002;54:175–81.CrossRefPubMed
16.
go back to reference Udassi JP, Udassi S, Theriaque DW, Shuster JJ, Zaritsky AL, Haque IU. Effect of alternative chest compression techniques in infant and child on rescuer performance. Pediatr Crit Care Med. 2009;10:328–33.CrossRefPubMedPubMedCentral Udassi JP, Udassi S, Theriaque DW, Shuster JJ, Zaritsky AL, Haque IU. Effect of alternative chest compression techniques in infant and child on rescuer performance. Pediatr Crit Care Med. 2009;10:328–33.CrossRefPubMedPubMedCentral
17.
go back to reference Neuzeret P-C, Morin L. Impact of different nasal masks on CPAP therapy for obstructive sleep apnea: a randomized comparative trial. Clin Respir J. 2016;11:990–98.CrossRefPubMed Neuzeret P-C, Morin L. Impact of different nasal masks on CPAP therapy for obstructive sleep apnea: a randomized comparative trial. Clin Respir J. 2016;11:990–98.CrossRefPubMed
18.
go back to reference Goel S, Mondkar J, Panchal H, Hegde D, Utture A, Manerkar S. Nasal mask versus nasal prongs for delivering nasal continuous positive airway pressure in preterm infants with respiratory distress: a randomized controlled trial. Indian Pediatr. 2015;52:1035–40.CrossRefPubMed Goel S, Mondkar J, Panchal H, Hegde D, Utture A, Manerkar S. Nasal mask versus nasal prongs for delivering nasal continuous positive airway pressure in preterm infants with respiratory distress: a randomized controlled trial. Indian Pediatr. 2015;52:1035–40.CrossRefPubMed
19.
go back to reference Ramanathan R. Nasal respiratory support through the nares: its time has come. J Perinatol. 2010;30(Supp 1):S67–72.CrossRefPubMed Ramanathan R. Nasal respiratory support through the nares: its time has come. J Perinatol. 2010;30(Supp 1):S67–72.CrossRefPubMed
20.
go back to reference Vignaux L, Vargas F, Roeseler J, Tassaux D, Thille AW, Kossowsky MP, Brochard L, Jolliet P. Patient–ventilator asynchrony during non-invasive ventilation for acute respiratory failure: a multicenter study. Intensive Care Med. 2009;35:840.CrossRefPubMed Vignaux L, Vargas F, Roeseler J, Tassaux D, Thille AW, Kossowsky MP, Brochard L, Jolliet P. Patient–ventilator asynchrony during non-invasive ventilation for acute respiratory failure: a multicenter study. Intensive Care Med. 2009;35:840.CrossRefPubMed
21.
go back to reference Vignaux L, Piquilloud L, Tourneux P, Jolliet P, Rimensberger PC. Neonatal and adult ICU ventilators to provide ventilation in neonates, infants, and children: a bench model study. Respir Care. 2014;59:1463–75.CrossRefPubMed Vignaux L, Piquilloud L, Tourneux P, Jolliet P, Rimensberger PC. Neonatal and adult ICU ventilators to provide ventilation in neonates, infants, and children: a bench model study. Respir Care. 2014;59:1463–75.CrossRefPubMed
22.
go back to reference Olivieri C, Costa R, Spinazzola G, Ferrone G, Longhini F, Cammarota G, Conti G, Navalesi P. Bench comparative evaluation of a new generation and standard helmet for delivering non-invasive ventilation. Intensive Care Med. 2013;39:734–8.CrossRefPubMed Olivieri C, Costa R, Spinazzola G, Ferrone G, Longhini F, Cammarota G, Conti G, Navalesi P. Bench comparative evaluation of a new generation and standard helmet for delivering non-invasive ventilation. Intensive Care Med. 2013;39:734–8.CrossRefPubMed
23.
go back to reference Yoder BA, Stoddard RA, Li M, King J, Dirnberger DR, Abbasi S. Heated, humidified high-flow nasal cannula versus nasal CPAP for respiratory support in neonates. Pediatrics. 2013;131:e1482–90.CrossRefPubMed Yoder BA, Stoddard RA, Li M, King J, Dirnberger DR, Abbasi S. Heated, humidified high-flow nasal cannula versus nasal CPAP for respiratory support in neonates. Pediatrics. 2013;131:e1482–90.CrossRefPubMed
24.
go back to reference Essouri S, Nicot F, Clement A, Garabedian E-N, Roger G, Lofaso F, Fauroux B. Noninvasive positive pressure ventilation in infants with upper airway obstruction: comparison of continuous and bilevel positive pressure. Intensive Care Med. 2005;31:574–80.CrossRefPubMed Essouri S, Nicot F, Clement A, Garabedian E-N, Roger G, Lofaso F, Fauroux B. Noninvasive positive pressure ventilation in infants with upper airway obstruction: comparison of continuous and bilevel positive pressure. Intensive Care Med. 2005;31:574–80.CrossRefPubMed
25.
go back to reference O'Donnell C, Kamlin C, Davis P, Morley C. Neonatal resuscitation 1: a model to measure inspired and expired tidal volumes and assess leakage at the face mask. Arch Dis Child Fetal Neonatal Ed. 2005;90:F388–91.CrossRefPubMedPubMedCentral O'Donnell C, Kamlin C, Davis P, Morley C. Neonatal resuscitation 1: a model to measure inspired and expired tidal volumes and assess leakage at the face mask. Arch Dis Child Fetal Neonatal Ed. 2005;90:F388–91.CrossRefPubMedPubMedCentral
26.
go back to reference Beck J, Reilly M, Grasselli G, Mirabella L, Slutsky AS, Dunn MS, Sinderby C. Patient-ventilator interaction during neurally adjusted ventilatory assist in low birth weight infants. Pediatr Res. 2009;65:663–8.CrossRefPubMedPubMedCentral Beck J, Reilly M, Grasselli G, Mirabella L, Slutsky AS, Dunn MS, Sinderby C. Patient-ventilator interaction during neurally adjusted ventilatory assist in low birth weight infants. Pediatr Res. 2009;65:663–8.CrossRefPubMedPubMedCentral
27.
go back to reference Shaffer TH, Alapati D, Greenspan JS, Wolfson MR. Neonatal non-invasive respiratory support: physiological implications. Pediatr Pulmonol. 2012;47:837–47.CrossRefPubMedPubMedCentral Shaffer TH, Alapati D, Greenspan JS, Wolfson MR. Neonatal non-invasive respiratory support: physiological implications. Pediatr Pulmonol. 2012;47:837–47.CrossRefPubMedPubMedCentral
28.
go back to reference Palme C, Nystrom B, Tunell R. An evaluation of the efficiency of face masks in the resuscitation of newborn infants. Lancet. 1985;1:207–10.CrossRefPubMed Palme C, Nystrom B, Tunell R. An evaluation of the efficiency of face masks in the resuscitation of newborn infants. Lancet. 1985;1:207–10.CrossRefPubMed
29.
go back to reference Milner AD, Vyas H, Hopkin IE. Efficacy of facemask resuscitation at birth. Br Med J. 1984;289:1563–5.CrossRef Milner AD, Vyas H, Hopkin IE. Efficacy of facemask resuscitation at birth. Br Med J. 1984;289:1563–5.CrossRef
Metadata
Title
Comparative bench study evaluation of different infant interfaces for non-invasive ventilation
Authors
Giorgio Conti
Giorgia Spinazzola
Cesare Gregoretti
Giuliano Ferrone
Andrea Cortegiani
Olimpia Festa
Marco Piastra
Luca Tortorolo
Roberta Costa
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2018
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-018-0620-x

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