To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recen...

Indications for administration of surfactant to infants with established respiratory distress syndrome (RDS; rescue therapy) remains an area of continued investigation. Current recommendations vary from use in infants who are intubated and have an aAPO2 <0.22 to use in infants receiving >/=40% oxygen administered in a hood when the PaO2 is <80 TORR (aAPO2 approximately <0.36). This commentary i...

Anecdotal reports suggest that obstructive sleep apnea syndrome (OSAS) patients may suffer from frequent nocturnal gastroesophageal reflux (GER) and that nasal continuous positive airway pressure may be an effective form of antireflux therapy in this population. To confirm these clinical impressions, we performed two consecutive days of 24-h esophageal pH monitoring, nocturnal esophageal pressu...

We studied two populations of patients who snored and had frequent nocturnal asthma attacks: ten overweight men presenting with typical obstructive sleep apnoea syndrome, and a group of five adolescents with regular snoring and an increase in negative inspiratory oesophageal pressure during stage II non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. All subjects presented cranio-...

We describe a new device for treating obstructive sleep apnea (OSA) which is similar to nasal CPAP, but less cumbersome. The device consists of a 7 mm diameter flexible tube terminating at one end in nasal prongs covered with foam cylinders. The foam cylinders are compressed, inserted into the nostrils and released, forming a tight seal. The other end of the catheter is attached to a compressor...

BACKGROUND CPAP is currently the treatment of choice for obstructive sleep apnea syndrome, but therapy adherence is poor. Many educational trials have been proposed to increase CPAP adherence. We tested the hypothesis that polysomnograph chart viewing by patients would improve CPAP adherence. METHODS A controlled parallel group study was performed with 206 newly diagnosed obstructive sleep ap...

Treatment strategies to address oxygenation problems in critically ill patients with hypoxemic respiratory failure commonly fall into 3 categories: use of simple oxygen equipment, use of noninvasive ventilation, or use of invasive ventilation. These categories typically represent a stepwise approach to the management of patients with increased levels of oxygen demands. High-flow nasal cannula (...