From the Guidelines
The chamber used for positive pressure in a neonatal unit is called a Continuous Positive Airway Pressure (CPAP) device or ventilator. These devices deliver a constant flow of air or oxygen at a prescribed pressure to help keep a newborn's airways open. For premature infants or those with respiratory distress, CPAP is often delivered through specialized interfaces such as nasal prongs, nasal masks, or facial masks connected to the pressure-generating machine. The positive pressure helps prevent alveolar collapse, improves oxygenation, and reduces the work of breathing for vulnerable neonates. In more severe cases requiring mechanical ventilation, the positive pressure may be delivered through an endotracheal tube in a ventilator system. The specific pressure settings (typically measured in centimeters of water, cmH2O) are carefully calibrated based on the infant's condition, weight, and respiratory needs, with continuous monitoring to prevent complications such as pneumothorax or oxygen toxicity. According to the most recent guidelines, including the 2023 American Heart Association and American Academy of Pediatrics focused update on neonatal resuscitation 1, the use of a supraglottic airway may be considered as the primary interface to administer positive-pressure ventilation instead of a face mask for newborn infants delivered at ≥34 0/7 weeks’ gestation 1. However, the fundamental principle of using CPAP for positive pressure in neonatal units remains consistent, as initially described in studies on respiratory support in preterm infants at birth 1.
Key considerations in the use of CPAP in neonatal units include:
- The selection of appropriate interfaces for CPAP delivery, such as nasal prongs or masks, which are tailored to the infant's size and condition.
- The careful adjustment of pressure settings to meet the individual needs of each infant, balancing the need for effective respiratory support with the risk of complications.
- Continuous monitoring of the infant's response to CPAP, including oxygen saturation, respiratory rate, and overall clinical condition, to ensure that the therapy is effective and safe.
From the Research
Chamber for Positive Pressure in Neonatal Unit
- The chamber used for positive pressure in a neonatal unit is related to the use of Continuous Positive Airway Pressure (CPAP) devices, which provide a constant flow of air pressure into the airways of the infant 2, 3, 4, 5, 6.
- Specifically, the term "bubble" is associated with Bubble Continuous Positive Airway Pressure (BCPAP), a type of CPAP that uses a chamber with water to create the positive pressure 2, 4, 5, 6.
- BCPAP has been shown to be effective in reducing the incidence of chronic lung disease and barotrauma in extremely low birth-weight infants 2.
- The use of BCPAP and other forms of CPAP requires careful management and nursing care to ensure optimal outcomes and prevent complications such as nasal septum injuries 2, 3, 4.