ABSTRACT
Introduction:Patients with COVID pneumonia, who did not respond to high‑flow oxygen by nonrebreathing mask (NRBM), needed additional support to deliver oxygen with pressure. We present our innovation to use Bain’s circuit to deliver continuous positive airway pressure (CPAP) along with 100% oxygen in patients with COVID‑19 when there was a shortage of respiratory support equipment. Materials and Methods: It is a retrospective observational study conducted at two high‑volume, government‑designated, tertiary level COVID centers of Northern India, during May and June 2021. After taking informed consent from all patients included in the study, a nonventilated noninvasive ventilation (NIV) mask was used as the interface between Bain’s circuit and the patient for making a tight seal. Vital parameters were recorded on admission, before putting the patient on Bain’s circuit, at 30 min, and 6 h after the initiation of Bain’s circuit. Results: Forty‑five patients were enrolled in this study. There was a significant reduction in the work of breathing after the application of Bain’s circuit. Vital parameters show improvement of the condition. Sensorium also showed a significant improvement after the application of Bain’s circuit. Overall, 40% of patients who received Bain’s circuit were weaned off to oxygen by NRBM, 31.1% of patients were bridged to NIV, and 28.9% of patients got intubated. Conclusion: The aim of presenting our experience is to generate interest regarding innovations in the face of crisis which may not be perfect but are practical for the situation. We do not recommend the use of Bain’s circuit to provide NIV support under normal circumstances. Further studies are needed to support the use of Bain’s circuit with modifications as a CPAP/NIV delivering device in selected patients.
ABSTRACT
Noninvasive high_frequency ventilation( NIHFV)is a new form of noninvasive ventilation which distends positive pressure continuously with oscillations superimposed on spontaneous tidal breathing,through a nonin_vasive interface. NIHFV,which provides the advantages of nasal continuous positive airway pressure and high frequency ventilation,can rapidly improve oxygenation,effectively remove carbon dioxide,and does not require synchronous techno_logy. It is considered as a new and effective noninvasive ventilation mode. In this paper,the application of NIHFV to neo_nates were reviewed,including mechanics of gas exchange,research advances and approach to the use of NIHFV.
ABSTRACT
Noninvasive high-frequency ventilation (NIHFV) is a new form of noninvasive ventilation which distends positive pressure continuously with oscillations superimposed on spontaneous tidal breathing, through a noninvasive interface.NIHFV, which provides the advantages of nasal continuous positive airway pressure and high frequency ventilation, can rapidly improve oxygenation, effectively remove carbon dioxide, and does not require synchronous techno-logy.It is considered as a new and effective noninvasive ventilation mode.In this paper, the application of NIHFV to neonates were reviewed, including mechanics of gas exchange, research advances and approach to the use of NIHFV.
ABSTRACT
Objective Investigate the effects of early application of noninvasive respiratory support on very low birth weight infant(VLBWI). Method A total of 65 VLBWI(born during September 2015 to September 2016 with 28-32 weeks gestational age;1000 g ≤ birth weight < 1500 g;exclusion of combination with congenital deformity)were randomly divided into the early application of noninvasive respiratory support as observation group (n = 33) and the application of endotracheal intubation with gen respiratory support as control group (n = 32). Comparison of two groups was carried out by SPSS in terms of incidence of endotracheal intubation,BPD,pulmonary infection,pneumothorax,and necrotizing enterocolitis,together with rescue ratio,total oxygenation time and hospitalization. Results No significant difference was found on incidence of pneumothorax,necrotizing enterocolitis and rescue ratio between two groups. The incidence of endotracheal intubation,BPD,pulmonary infection and total oxygenation time was markly decreased in observation group. Conclusion Early application of noninvasive respiratory support benefits VLBWI via reducing incidence of endotracheal intubation,BPD,pulmonary infection, total oxygenation time.