Hi All,

Infant Flow/Inspire/First Breath/LP nCPAP generators are limited to XL masks and XL prongs and headgear. What do units do when a baby outgrows the largest sizes? This is a question I'm being asked more and more, despite it not being a new problem.

Any suggestions of work arounds or equipment greatly received.

Regards Owen

Hello everyone,

I realise this is a challenging issue. From my experience, infants over 2-3 months old often don’t tolerate CPAP masks very well. That’s why, whenever possible, we tend to switch to Optiflow cannulas and Airvo devices, which can be more comfortable for them. When an infant with BPD needs “true” non-invasive ventilation, I believe that, unfortunately, a tracheotomy might be the most practical option. The good news is that we only encounter a few such cases each year. In Poland, there’s a significant challenge in accessing quality non-invasive ventilation covered by health insurance. The available options tend to be more suitable for older children and adults. Usually, patients with chronic respiratory failure are cared for at home by an adult anesthesiologist, which adds another layer to the situation.

Simple answer to your question is transfer them at that age to PICU, they often manage such babies quite comfortably

Thank you both.

The other dimension was from A&E where they have the potential to cover this population coming through the door (albeit rarely). Optiflow and Airvo are very helpful. Thank you.

Hi,

We used the following for infants typically CGA at or after 44 weeks gestation who still require CPAP support.  Most are recovering from a CLD