Intensive Care Medicine

, Volume 36, Issue 12, pp 2094–2100

Noninvasive high frequency oscillatory ventilation through nasal prongs: bench evaluation of efficacy and mechanics

  • Daniele De Luca
  • Virgilio P. Carnielli
  • Giorgio Conti
  • Marco Piastra
Pediatric Original

DOI: 10.1007/s00134-010-2054-7

Cite this article as:
De Luca, D., Carnielli, V.P., Conti, G. et al. Intensive Care Med (2010) 36: 2094. doi:10.1007/s00134-010-2054-7

Abstract

Background

Noninvasive high frequency oscillatory ventilation through nasal prongs (nHFOV) has been proposed as a new respiratory support in neonatology. We studied the effect of ventilation parameters and nasal prongs on nHFOV efficacy and mechanics.

Methods

Customized sealed circuits connecting a SM3100A oscillator to a neonatal lung model were developed to evaluate the effect of applying HFOV via two different sized nasal prongs on delivered tidal volume and pressure. Measurements were made across a range of frequencies and pressures; amplitude was set to obtain visible lung oscillation.

Results

Volume delivered by peak-to-peak oscillation, ventilation, and pressure significantly differed among the interfaces, being higher for large cannulae and the control circuit (p < 0.0001). The interposition of a large or small nasal prong reduced volume to 56 and 26%, ventilation to 32 and 9%, and mean pressure to 83 and 79%, respectively, of the values measured for the direct connection of the oscillator to the test lung. Volume and ventilation were inversely related to frequency, which was particularly evident with larger diameter circuits due to higher delivered tidal volume (R2 > 0.9). Increasing ventilation was associated with larger tidal volume and nasal prong diameter (adjusted R2 = 0.97).

Conclusions

nHFOV using common nasal prongs is technically possible. Efficiency of tidal volume delivery is significantly affected by prong diameter.

Keywords

Bench study HFOV Noninvasive ventilation Preterm neonate 

Abbreviations

CO2

Carbon dioxide

DCO2

Ventilation during HFOV

HFOV

High frequency oscillatory ventilation

Tv

Tidal volume

nHFOV

Nasal noninvasive high frequency oscillatory ventilation

nCPAP

Nasal continuous positive airway pressure

Paw

Mean pressure at the airway opening

ΔP

Peak-to-peak pressure amplitude

PL

Distal pressure measured at the lung model

Copyright information

© Copyright jointly held by Springer and ESICM 2010

Authors and Affiliations

  • Daniele De Luca
    • 1
    • 4
  • Virgilio P. Carnielli
    • 1
    • 2
  • Giorgio Conti
    • 3
  • Marco Piastra
    • 3
  1. 1.Division of Neonatology and Institute of Mother and Child Health, “G.Salesi” Women and Children HospitalPolytechnical University of MarcheAnconaItaly
  2. 2.Institute of Child Health and Great Ormond Street HospitalLondonUK
  3. 3.Pediatric Intensive Care Unit, Department of Emergency and Intensive CareCatholic University of the Sacred HeartRomeItaly
  4. 4.RomeItaly

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