The Continuous Positive Airways Pressure, also known as CPAP, is a kind of ventilation that is done to the respiratory system whose major purpose is to treat sleep apnea. However, research has indicated that newborn infants can also benefit from this system. The mechanism of action of CPAP for infants is that it spontaneously supports their breathing, especially if they are suffering from lung conditions (Goldsmith & Karotkin, 2011). The use of CPAP in infants has been around for almost forty years now. There are various CPAPS for infants, and each one of them has its advantages and disadvantages, pros and cons, hazards, and benefits, which should be analyzed for the benefit of those who may want to use them in future.
Bubble CPAP
A Bubble CPAP is an infant CPAP device that was discovered by Dr. Wung. It is used to deliver oxygen to the lungs of a newborn to maintain their lung volumes especially when they are breathing out. It delivers humidified and mixed oxygen through a nasal mask. The pressure within the circuit is sustained by dipping the distal side of the tubing into water. It has been used for over 40 years.
This particular CPAP is appealing to many people because of its affordability. It can be acquired by paying a small amount of money as a down payment (Kuenhe & Wishloff, 2011). Also, it is something that one can use for an extended period. If the vent circuit has a hitch, one only needs to modify it instead of buying a new one. The CPAP is also easy to use since it is very simple in structure. Compared to the mechanical ventilation, the rate of occurrence of bronchopulmonary dysplasia is substantially reduced when using the Bubble CPAP.
Besides, the Bubble CPAP is also available in various interfaces. Such diversity ensures that the device covers different categories of patients and not just the infants. Further, the bubbling that this CPAP initiates is used to facilitate gaseous exchange. Lastly, it is hard for the gaseous exchange to be reproduced making the device relatively safe.
However, the device does not contain any built-in monitors. This makes it difficult to analyze instances of high-pressure vis-Ã -vis the change in pressure. Also, it is hard for one to notice if there is a disconnection in the system. Furthermore, the lack of monitors makes it hard for one to combat apnea.
Another disadvantage is that the Bubble-CPAP can increase the amount of effort that is necessary to force air into the lungs. This may put a strain on the infant instead of helping them breathe easily..
Continuous Flow NCPAP
Compared to the B-CPAP, the usage of CF NCPAP began earlier. The prongs of CF NCPAP are linked between the expiratory and inspiratory limbs of its ventilator (Pk, 2011). Thus, the CPAP is determined by tweaking the flow and PEEP of the device. In fact, it is used as a model CPAP for other new CPAPs.
According to various literature, the CF NCPAP has been used for around 35 years. The implication of this is that it has been an effective system (Pk, 2011). Additionally, caregivers have reported that they are very comfortable with its performance as compared to the Bubble CPAP.
Nevertheless, it has other undesirable aspects. For instance, caregivers prefer other CPAPs such as Bubble CPAP to it. Its overall performance has also been proven to lag behind other similar products. Moreover, it can lead to the retention of CO2 in the system (Kuenhe & Wishloff, 2011), which is dangerous to the health of the infant. The retention may in turn lead to respiratory fatigue leading to breathing problems. Like the bubble CPAP, the CF CPAP also leads to increased work of breathing (WOB).
Nasal-Intermittent Positive Pressure Ventilation
The NIPPV is a form of CPAP that is an upgrade on CF CPAP. As a matter of fact, it is a contemporary device since it delivers pressure in two ways. The already discussed CPAPs only deliver pressure using a single system. According to White (2014) its potential benefits include a reduction in the frequency of occurrence of apnea. It also increases the expiration of CO2 from the body. Unlike the other CPAPs, it reduces work of breath (WOB). Also, it uses the latest technology making it very effective.
Unlike the other CPAPs, the NIPPV is an expensive equipment making it unaffordable to a wide range of people. Its hazard entails the potential to cause dysynchrony that may be prompted by the trigger. This is dangerous to the general wellbeing of the infant.
Variable Flow NCPAP
The VF NCPAP is a complex, hence more effective system when it comes to breathing problems that afflict infants (Esquinas, 2012). It is easy to use because it has a free standing technique. When it was compared to other CPAPs, it was realized that it delivers pressure exactly as prescribed by the neonatologists. Its effectiveness is further augmented by its monitors and safety valve that it uses to dump air (Esquinas, 2012). Nonetheless, the VF NCPAP is a very expensive system. To buy it, one has to, first of all, pay a very expensive down payment.
Trends in NCPAP
Trends in CPAP include a sealing flange that is softer, lighter weight, ease of use, adaptability to multifarious geometries, better sealing among others (White, 2014). The CPAP systems are increasingly becoming connected and smart. The latest devices have masks that are applied easily while they are also more pliable compared to the earlier ones.
References
Esquinas, A. M. (2012). Humidification in the intensive care unit: The essentials. Philadelphia, PA : Springer Science & Business Media. Web.
Goldsmith, J. P., & Karotkin, E. H. (2010). Assisted ventilation of the neonate. St. Louis, MO: Elsevier Health Sciences. Web.
Kuenhe, B., & Wishloff, E. (2011). What type of CPAP and why. Columbus, OH: Neonatal Respiratory Services Nationwide Children’s Hospital Columbus. Web.
Pk, R. (2011). CPAP (Continuous positive airway pressure) bedside application in the newborn. London, : JP Medical Ltd. Web.
White, G. (2014). Equipment theory for respiratory care. Boston , MA: Cengage Learning. Web.