Tidal volume transmission during non-synchronized nasal intermittent positive pressure ventilation via RAM® cannula

• DOI: 10.1038/s41372-019-0333-x
• Publication Date: 2019-02-12T11:05:20Z
• Authors: David N. Matlock; Shasha Bai; Michael D. Weisner; Norman Comtois; Jennifer Beck; Christer Sinderby; Sherry E. Courtney
• Keywords: Nasal cannula; Respiratory minute volume; Plethysmograph

Nasal intermittent positive pressure ventilation (NIPPV) is a widely used mode of support in neonates, during which ventilator inflations may or may not coincide with spontaneous breathing.We tested the hypothesis that inflations delivered with NIPPV via RAM® cannula and not accompanied by patient effort produce minimal tidal volume as measured by respiratory inductance plethysmography.Fourteen subjects were monitored while receiving NIPPV. We compared tidal volumes during ventilator-supported breaths, unsupported breaths, and ventilator inflations not accompanied by patient effort (defined using electrical activity of the diaphragm).Mean tidal volumes in arbitrary units were 0.30 ± 0.22 in NIPPV inflations associated with patient effort and 0.27 ± 0.15 in spontaneous breaths without ventilator assistance (p = 0.82). Tidal volumes during ventilator-only inflations were 0.06 ± 0.04 (p < 0.005 vs. both ventilator-assisted and unassisted efforts).NIPPV via RAM cannula produces minimal, clinically insignificant tidal volumes during non-spontaneous inflations.