Posted April 13, 201212 yr hi we work in under sourced circumstances there fore cpap and vents are available in vey few centers and many of our pts suffer .while searching i came across a simple manual oxygen source to under water seal circuit,as we hv no experience with it can any body share on this or any other methods also if any body can inform us about donors for cpap or vent thnks my source was utube bubble cpap/docrajesh75@yahoo.com
April 13, 201212 yr No experience with buble cpap, but check out the benveniste valve for CPAP. http://www.dameca.dk/produkter/neonataludstyr/ventilen-med-studs.aspx It has been the primary mode of ventilatory support for neonates in Denmark for three decades. Very easy to use, the valve is comparatively cheap (aprox 300 $ ) and made to be reused ( I don`t know if its still copyright protected, but i think manufacturing should be quite simple and feasible in most corners of the world) . The danish pediatric society has a cooperation with Cuba helping introducing it there, and I think it has been used in India as well. What part of the world are you practicing in ?
April 13, 201212 yr Hi Dr Ayub I'm glad to share with you our experience with the bubble CPAP. I'm a Neonatologist in Dominican Republic and we have a very good experience with it. To make the CPAP you will need a neonatal oxygen nasal canula,a 3 way stopcock ,2 pieces of plastic hose, a saline solution plastic bottle, centimeter, Z-O, and a source of oxygen. First prepare the bottle. Empty the saline a little more than half way,with a blade open a slit and pass through it one hose ( you can use an IV line ).Make a presssure guide with the centimeter and the Z-O, stick it in the bottle from the bottom up. Conect to the 3 way stopcock, then conect the nasal canula ( you need to cut it to make it fit), and the oxygen hose. When everything is in place you need to see the bubbles in the saline to know is working properly. We begin with 3-4 lts of O2, and 3-4 cms of pressure. Move with clinical condition and oxygen sat. The tip of the saline hose is what you will move up or down to change the pressure. It really help.. and its not hard to make. Our nurses do it in a blink, it only takes practice. Give it a try. I hope this is clear enough to help you. This is the beauty of 99 NICU. Best wishes for you and your babies.Leonora
April 16, 201212 yr thanks dear padkaer,i practicing n pakistan it province calld Balochistan v v backword area.if you have danish pediatric society emil. thankful
April 17, 201212 yr how u will take care of FIO2 in this system of bubble CPAP? Use a blender - needs O2 and Air supply - Example : http://www.viamed.co.uk/eng/?uid=&sessionid=&page=catagory&cat=360&subcat=419 Another example: http://www.biomeddevices.com/index.html?neo_blend.html&3 or use a room air plus O2 blender Eg: - http://www.nascor.com.au/public_html/business/pdf/oxygen-air-mixer-brochure.pdf (I am not sure if the last example is made for use in a cpap circuit but I am sure it can be made to work !!! )
April 18, 201212 yr We also use Bubble CPAP with a good results... We have a small air compressor here, so we can lower the FiO2.. Don't need any oxygen blender (before that, we use to use a venturi adaptor..kind of work though)... With the 2 gas source, you're going to need 2 flowmeters (oxygen and air) blended together with the three way (FiO2 is calculated with concentration formula : V1M1xV2M2=V3M3)... But you need to use a humidifier to... Dry and cold gas is not good for the baby.. I don't see a humidifier in Leonora's CPAP..
April 23, 201212 yr We use an humidifier in our oxygen source sorry I forgot to mention it. We don't have a way of making it warm. This is not perfect but does saves lives. Regards. Leonora
May 4, 201212 yr In india also this kind of bubble CPAP have been used with good results....can be used where bubble cpap machines are not available....difficulties regarding FiO2 and warming & humidification exists
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