In vitro comparison of performance including imposed work of breathing of CPAP systems used in low-resource settings

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dc.citation.articleNumbere0242590en_US
dc.citation.issueNumber12en_US
dc.citation.journalTitlePLoS ONEen_US
dc.citation.volumeNumber15en_US
dc.contributor.authorHeenan, Meganen_US
dc.contributor.authorRojas, Jose D.en_US
dc.contributor.authorOden, Z. Mariaen_US
dc.contributor.authorRichards-Kortum, Rebeccaen_US
dc.contributor.orgBioengineeringen_US
dc.contributor.orgRice 360 Institute for Global Healthen_US
dc.date.accessioned2021-02-08T18:38:00Zen_US
dc.date.available2021-02-08T18:38:00Zen_US
dc.date.issued2020en_US
dc.description.abstractRespiratory distress due to preterm birth is a significant cause of death in low-resource settings. The introduction of continuous positive airway pressure (CPAP) systems to treat respiratory distress significantly reduced mortality in high-resource settings, but CPAP was only recently introduced in low-resource settings due to cost and infrastructure limitations. We evaluated pressure stability and imposed work of breathing (iWOB) of five CPAP systems used in low resource settings: the Fisher and Paykel bubble CPAP, the Diamedica baby CPAP, the Medijet nCPAP generator, and the first (2015) and second (2017) generation commercially available Pumani CPAPs. Pressure changes due to fresh gas flow were evaluated for each system by examining the relationship between flow and pressure at the patient interface for four pressures generated at the bottle (0, 3, 5, and 7 cm H2O); for the Medijet nCPAP generator, no bottle was used. The slope of the resulting relationship was used to calculate system resistance. Poiseuille’s law of resistance was used to investigate significant contributors to resistance. Resistance ranged from 0.05 to 1.40 ; three CPAP devices had resistances < 0.4 : the Fisher and Paykel system, the Diamedica system, and the second generation Pumani bubble CPAP. The other two systems, the Medijet nCPAP generator and the first generation Pumani bCPAP, had resistances >1.0 . Imposed WOB was measured using an ASL5000 test lung to simulate the breath cycle for an infant (5.5 kg), a term neonate (4.0 kg), and a preterm neonate (2.5 kg). Imposed WOB ranged from 1.4 to 39.5 mJ/breath across all systems and simulated infant sizes. Changes in pressure generated by fresh gas flow, resistance, and iWOB differ between the five systems evaluated under ideal laboratory conditions. The available literature does not indicate that these differences affect clinical outcomes.en_US
dc.identifier.citationHeenan, Megan, Rojas, Jose D., Oden, Z. Maria, et al.. "In vitro comparison of performance including imposed work of breathing of CPAP systems used in low-resource settings." <i>PLoS ONE,</i> 15, no. 12 (2020) Public Library of Science: https://doi.org/10.1371/journal.pone.0242590.en_US
dc.identifier.digitalpone-0242590en_US
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0242590en_US
dc.identifier.urihttps://hdl.handle.net/1911/109824en_US
dc.language.isoengen_US
dc.publisherPublic Library of Scienceen_US
dc.rightsThis is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en_US
dc.titleIn vitro comparison of performance including imposed work of breathing of CPAP systems used in low-resource settingsen_US
dc.typeJournal articleen_US
dc.type.dcmiTexten_US
dc.type.publicationpublisher versionen_US
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