pediatrics
Respiratory Support in Neonates and Infants
CPAP for Neonates and Infants
In CPAP, constant pressure is maintained throughout the respiratory cycle, usually 5 to 7 cm H2O, but with no additional inspiratory pressure support. CPAP keeps alveoli open and improves oxygenation by reducing atelectasis and thereby the amount of blood shunted through atelectatic areas while the infant breathes spontaneously. CPAP can be provided using nasal prongs or masks and various apparatuses to provide the positive pressure; it also can be given using an endotracheal tube connected to a conventional ventilator with the rate set to zero. ( CPAP references ) is a low-technology way of providing CPAP in which the outflow tubing is simply immersed in water to provide expiratory resistance equal to the depth of the tubing in the water (exhalation makes the water bubble, hence the name). 40% is required to maintain acceptable PaO2 (50 to 70 mm Hg) in infants with respiratory disorders that are of limited duration (eg, diffuse Atelectasis , mild Common complications of nasal CPAP are gastric distention, aspiration, pneumothorax, and Staging systems . The need for increasing FIO2 and/or pressure are signs that intubation may be necessary ( 1.Gupta S, Donn SM: Continuous positive airway pressure: To bubble or not to bubble?Clin Perinatol43(4):647–659, 2016. doi: 10.1016/j.clp.2016.07.003 2.Fedor KL: Noninvasive respiratory support in infants and children.Respir Care62(6):699–717, 2017. doi: 10.4187/respcare.05244 