functionally similar to PEEP, but the positive pressure is delivered throughout the
breath cycle.
- Bilevel positive airway pressure (BPAP)
BPAP is another modaility of non-invasive ventilation. It delivers a set
inspiratory positive airway pressure (IPAP) and expiratory positive airway
pressure. Tidal volume is determined by the difference between IPAP and EPAP.
There is limited availabity of FDA-approved interfaces in the infant and pediatric
population. - Nasal Intermittent Mandatory Ventilation
Nsal IMV is an intermediate strategy for neonates weaned off from
mechanical ventilation but require more than CPAP. The most common mode used
is a time cycle, pressure control with our without preset constant flow. Unassisted
breaths occur at present PEEP level. Pressure control breaths can be triggered by
the patient or machine. Pressure support ventilation cannot be used for nasal AMV
because because it cannot flow cyle breaths due to the airway weak.
The main challenge of noinvasive ventilation in children, expecially infants, is
the limited availability of interfaces to deliver this type of ventilation. Current
available inerfaces for non invasive ventilation include face mask, short prong nasal
cannula, intermediate size high flow nasal cannula •nasal cannula (Fisher Paykel,
Auckland, New Zealand), or a RAM nasal cannula (NeoTech, Valencia, California).
The RAM cannulae possess a larger-bore tubing than a standard oxygen or high-