Are high flow nasal cannulae noisier than bubble CPAP for preterm infants?

Background Noise exposure in the neonatal intensive care unit is believed to be a risk factor for hearing loss in preterm neonates. Continuous positive airway pressure (CPAP) devices exceed recommended noise levels. High flow nasal cannulae (HFNC) are an increasingly popular alternative to CPAP for...

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Vydáno v:Archives of disease in childhood. Fetal and neonatal edition Ročník 99; číslo 4; s. F291 - F296
Hlavní autoři: Roberts, C T, Dawson, J A, Alquoka, E, Carew, P J, Donath, S M, Davis, P G, Manley, B J
Médium: Journal Article
Jazyk:angličtina
Vydáno: London BMJ Publishing Group 01.07.2014
BMJ Publishing Group LTD
Témata:
Biological and medical sciences
Catheters
Continuous positive airway pressure
Continuous Positive Airway Pressure - adverse effects
Continuous Positive Airway Pressure - instrumentation
Continuous Positive Airway Pressure - methods
Delivery. Postpartum. Lactation
Environmental Monitoring - methods
Gas flow
Gynecology. Andrology. Obstetrics
Hearing loss
High flow
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases - therapy
Infants
Intensive Care Units, Neonatal
Maternal, fetal and perinatal monitoring
Medical sciences
Nasal Cavity
Neonates
Noise
Noise - adverse effects
Noise levels
Noninvasive Ventilation - adverse effects
Noninvasive Ventilation - instrumentation
Noninvasive Ventilation - methods
Observational studies
Premature birth
Risk factors
Sound
Studies
Terminology as Topic
Womens health
High
Premature
Newborn diseases
Prematurity
Nose
ISSN:1359-2998, 1468-2052, 1468-2052
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Popis
Shrnutí:Background Noise exposure in the neonatal intensive care unit is believed to be a risk factor for hearing loss in preterm neonates. Continuous positive airway pressure (CPAP) devices exceed recommended noise levels. High flow nasal cannulae (HFNC) are an increasingly popular alternative to CPAP for treating preterm infants, but there are no in vivo studies assessing noise production by HFNC. Objective To study whether HFNC are noisier than bubble CPAP (BCPAP) for preterm infants. Methods An observational study of preterm infants receiving HFNC or BCPAP. Noise levels within the external auditory meatus (EAM) were measured using a microphone probe tube connected to a calibrated digital dosimeter. Noise was measured across a range of frequencies and reported as decibels A-weighted (dBA). Results A total of 21 HFNC and 13 BCPAP noise measurements were performed in 21 infants. HFNC gas flows were 2–5 L/min, and BCPAP gas flows were 6–10 L/min with set pressures of 5–7 cm of water. There was no evidence of a difference in average noise levels measured at the EAM: mean difference (95% CI) of −1.6 (−4.0 to 0.9) dBA for HFNC compared to BCPAP. At low frequency (500 Hz), HFNC was mean (95% CI) 3.0 (0.3 to 5.7) dBA quieter than BCPAP. Noise increased with increasing BCPAP gas flow (p=0.007), but not with increasing set pressure. There was a trend to noise increasing with increasing HFNC gas flows. Conclusions At the gas flows studied, HFNC are not noisier than BCPAP for preterm infants.
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ISSN:1359-2998
1468-2052
1468-2052
DOI:10.1136/archdischild-2013-305033