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BubbleCPAP. Classical nCPAP system

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BubbleCPAP

In the case of the BubbleCPAP, positive pressure is applied to the airways during inspiration and expiration. Pressure is generated through the expired breathing gas being directed into a water container (bubbler). A dip tube (surge chamber) is on the end of the expiratory ventilation tube. The level of the CPAP pressure depends on how deep the end of the cylinder is immersed into the sterile water.

  • Classical nCPAP system – used worldwide
  • All the advantages of nCPAP therapy
  • Economical and universally applicable
  • Easy to use
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Easy application

This simple CPAP system was used for the first time in the early 1970s (Gregory GA, Kitterman JA, Phibbs RH, Tooley WH, Hamilton WK. Treatment of the idiopathic respiratory-distress syndrome with continuous positive airway pressure. N Engl J Med. 1971;284(24):1333-1340. doi:10.1056/NEJM1971061728424011​) and it has been used worldwide since then. In 1987, it was demonstrated (Avery ME, Tooley WH, Keller JB, et al. Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. Pediatrics. 1987;79(1):26-30. 2​) that the incidence of BPD (bronchopulmonary dysplasia) can be reduced using BubbleCPAP. As a result, the system presumably became the most frequently used CPAP application by this time at the latest.

It consists only of:

  • Air/oxygen blender: medinBLENDER
  • Bubble bottle for CPAP pressures of 0 to 9.5 cm H2O
  • Breathing circuit: 2-tube system 5801 HAMILTON-H900
  • Respiratory gas humidifier HAMILTON-H900
  • nCPAP interface: Hamilton nCPAP Generator with masks and prongs

Mechanisms of acition

The mechanisms of action of the CPAP pressure are:

  • Holding the airways open through positive pressure
  • Increasing the FRC (functional residual capacity)
  • Increasing the respiratory drive through improved oxygenation
  • Reducing the breathing effort
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References

  1. 1. Gregory GA, Kitterman JA, Phibbs RH, Tooley WH, Hamilton WK. Treatment of the idiopathic respiratory-distress syndrome with continuous positive airway pressure. N Engl J Med. 1971;284(24):1333-1340. doi:10.1056/NEJM197106172842401

 

  1. 2. Avery ME, Tooley WH, Keller JB, et al. Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. Pediatrics. 1987;79(1):26-30.

Footnotes

 

Treatment of the idiopathic respiratory-distress syndrome with continuous positive airway pressure.

Gregory GA, Kitterman JA, Phibbs RH, Tooley WH, Hamilton WK. Treatment of the idiopathic respiratory-distress syndrome with continuous positive airway pressure. N Engl J Med. 1971;284(24):1333-1340. doi:10.1056/NEJM197106172842401

Is chronic lung disease in low birth weight infants preventable? A survey of eight centers.

Avery ME, Tooley WH, Keller JB, et al. Is chronic lung disease in low birth weight infants preventable? A survey of eight centers. Pediatrics. 1987;79(1):26-30.

Chronic lung disease in prematurely born infants, defined as the need for increased inspired oxygen at 28 days of age, was thought to be more common in some institutions than in others. To test this hypothesis, we surveyed the experience in the intensive care nurseries at Columbia and Vanderbilt Universities, the Universities of Texas at Dallas, Washington at Seattle, and California at San Francisco, the Brigham and Women's Hospital in Boston, Texas Children's Hospital in Houston, and Mt Sinai Hospital in Toronto. The survey included 1,625 infants with birth weights of 700 to 1,500 g. We confirmed the relationship of risk to low birth weight, white race, and male sex. Significant differences in the incidence of chronic lung disease were found between institutions even when birth weight, race, and sex were taken into consideration through a multivariate logistic regression analysis. Columbia had one of the best outcomes for low birth weight infants and the lowest incidence of chronic lung disease.