A COMPARISON OF UNDERWATER BUBBLE CONTINUOUS POSITIVE AIRWAY PRESSUREWITH VENTILATOR-DERIVED CONTINUOUS POSITIVE AIRWAY PRESSURE IN PREMATURE NEONATES READY FOR EXTUBATION

Objective and methods: As the result of vigorous bubbling, infants rec eiving continuous positive airway pressure (CPAP) by an underwater sea l (bubble CPAP) were observed to have vibrations of their chests at fr equencies similar to high-frequency ventilation (HFV), We performed a randomized crossover study in 10 premature infants ready for extubatio n to test whether bubble CPAP contributes to gas exchange compared to conventional ventilator-derived CPAP. Measurements of tidal volume and minute volume were made using the Bear Cub neonatal volume monitor, a nd gas exchange was measured using an oxygen saturation monitor and a transcutaneous carbon dioxide (tcpCO(2)) monitor. Results: There was a 39% reduction in minute volume (p < 0.001) and a 7% reduction in resp iratory rate (p = 0.004) with no change in tcpCO(2) or O-2 saturation for infants supported with bubble versus ventilator-derived CPAP. Conc lusions: The lack of difference in blood gas parameters associated wit h a decrease in the infant's minute volume and respiratory rate with b ubble CPAP compared with ventilator-derived CPAP suggests that the che st vibrations produced with bubble CPAP may have contributed to gas ex change. Bubble CPAP may offer an effective and inexpensive option for providing respiratory support to premature infants.