Pneumatic Performance of the Boussignac CPAP System in Healthy Humans

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Abstract:

BACKGROUND: The Boussignac continuous positive airway pressure (CPAP) device effectively treats acute pulmonary edema, but data on airway pressure with the Boussignac CPAP system are sparse. OBJECTIVE: To evaluate the Boussignac CPAP system's ability to maintain stable inspiratory and expiratory pressure levels, and to evaluate perceived exertion during breathing with the Boussignac CPAP system. METHODS: With 18 healthy volunteers we recorded airway pressure and air flow during 10-min sessions at 5.0, 7.5, and 10.0 cm H2O. The participants were blinded to the sequence of the CPAP levels. Each session was ended with 10 forced breaths. We measured perceived exertion with the Borg category ratio 10 (Borg CR10) scale. RESULTS: When the participants breathed at 20% of vital capacity and a peak expiratory flow of 14% of FEV1, the maximum pressure difference between inspiration and expiration was 4.0 cm H2O at CPAP 10 cm H2O. The changes in airway pressure were never large enough to reduce airway pressure to below zero. During the forced breaths, the expiratory volume was 38‐42% of vital capacity and peak expiratory flow was 49‐56% of FEV1. As air flow increased, both the drop in inspiratory airway pressure and the increase in expiratory airway pressure increased. CONCLUSIONS: With CPAP, pressure changes are considered to be associated with increased work of breathing. The device's pneumatic performance is adequate during normal breathing with low air flow, but during forced breathing (high air flow) it did not maintain stable airway pressure, which could increase the work of breathing and cause respiratory fatigue. Thus, the Boussignac CPAP system might be less suitable for a patient breathing at a higher frequency.

Keywords: Borg CR10 scale; CPAP; air flow; airway pressure; continuous positive airway pressure; flow resistor; noninvasive ventilation

Document Type: Research Article

DOI: http://dx.doi.org/10.4187/respcare.01015

Affiliations: Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden.

Publication date: June 1, 2011

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