OBJECTIVE To compare the effect of continuous positive airway pressure (CPAP) with synchronous intermittent mandatory ventilation (SIMV) during weaning, by measurement of the pressure time product (PTP). The PTP is an estimate of the metabolic work or oxygen consumption of the respiratory muscles. PATIENTS Forty children, median age 14 months (range 1 month to 17 years) were studied immediate...

BACKGROUND The rapid-shallow-breathing index (RSBI) is widely used to evaluate mechanically ventilated patients for weaning and extubation, but it is determined in different clinical centers in a variety of ways, under conditions that are not always comparable. We hypothesized that the value of RSBI may be significantly influenced by common variations in measurement conditions and technique. ...

Continuous positive airway pressure in congenital lobar emphysema Congenital lobar emphysema with air trapping distal to defective bronchial cartilage is an unusual cause of respiratory distress in early infancy.' Prompt treatment, usually lobectomy, may be necessary to maintain ventilation. Until recently medical management had little to offer; indeed, mortality was likely to be increased by t...

Although nasal continuous positive airway pressure (CPAP) is effective in the treatment of most patients with obstructive sleep apnea (OSA), there is a small group of such patients in whom rapid eye movement (REM) hypoventilation and CO2 retention persist despite the use of CPAP and supplemental oxygen. In this report we describe our experience with nocturnal nasal ventilation (nocturnal nasal ...

This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, ...

BACKGROUND Respiratory distress syndrome remains a significant problem among premature infants. Mechanical ventilation through an endotracheal tube remains the mainstay of respiratory support but may be associated with lung injury and the development of chronic lung disease of prematurity. Efforts are needed to reduce the duration of mechanical ventilation in favour of less invasive forms of re...

BACKGROUND For patients with chronic respiratory failure or sleep breathing disorders, adaptation and training are important prerequisites for successful home noninvasive ventilation (NIV) and CPAP. In Europe, management of NIV/CPAP is sometimes performed by physiotherapists (PTs). However, their role within the NIV/CPAP management team is not well defined. OBJECTIVE To describe the implement...

As evidenced by the recent trials, a large proportion of infants can be adequately managed with CPAP, with comparable rates of BPD to those achieved in mechanically ventilated infants.2,3 These trials also made clear that a significant proportion of infants initially started on CPAP eventually require mechanical ventilation, which was more evident among infants of lower gestational age. In the ...

Abstract The worldwide shortage of medical-grade ventilators is a well-known issue, that has become one the central topics during COVID-19 pandemic. Given these machines are expensive and have long lead times, approach to vacate them for patients in critical conditions while with mild moderate symptoms treated stripped-down ventilators. We propose mass-producible solution can create such minimu...

STUDY OBJECTIVE We evaluated the difference in work of breathing (WOB) during spontaneous ventilation with continuous positive airway pressure (CPAP) among three methods of triggering the ventilator: conventional pressure triggering, tracheal pressure triggering, and flow-by triggering. METHODS In an in vitro model of the respiratory system consisting of a bellows (lungs) in a plastic caniste...