SiPAP

[Guest sjbrott]

Is SiPAP being used in most NICU's?

[ctestolin]

We Are using Sipap and we have really good results. Do anyone know a leading article ON sipap and premies? Which settimg of sipap Are you using?

Edited September 9, 2009 by JACK

[hkhawahur]

in the litterature it is mentioned that the rate of failure of extubatin is less ( ie rate of rintubation is less) in somebody who already needed reintubation with N-CPAP with the use of SIPAP .

[Guest Dukstar]

What do you mean by SIPAP (and the difference between N-CPAP) ?

Thanks for any explanation

[JACK]

Nasal CPAP refers to a continuous fixed positive airway pressure level applied by the machine. For example a CPAP of 5 cmH2O, delivers a pressure of 5 cm H2O continuously

In SiPAP, there are two pressure levels set. The lower level and the higher level. The higher pressure is delivered at a rate fixed by the operator. The shift from the lower pressure to the higher pressure level is a 'sigh'. The time for which the higher pressure level is applied is the Ti. For example with the settings of lower pressure level = 5 , higher = 7 , Ti= 1 sec, Rate 10 /min, the baby will get a cpap of 5 cm H2O continuously but with intermittent increase of the pressure level to 7 cm H2o lasting for 1 sec. These increased levels of pressure will occur at a rate of 10 per minute.

[ctestolin]

I have some doubts: in our unit we use such SiPAP setting, but in literature I always found setting of SiPAP as a nasal SIPPV. DO you know where I can find setting similar to those we use to do?

[JACK]

I found the following online resources

http://nursing.uchc.edu/unit_manuals/respiratory/nicu_respiratory/docs/Infant%20Flow%20SiPAP.pdf

http://www.newbornnetworks.org.uk/staffs/documents/SiPAPtrainingsession.pdf

http://www.summittechnologies.ca/clinical/SiPAP%20-%20Strategy%20Implementation%20Guide2%20-%20L2633.pdf

[ctestolin]

Thanks Jack for your help.

I didn't find any article on bilevel SiPAP? Do you?

[JACK]

...bilevel SiPAP..

I think SiPAP is nothing but a form of bilevel nasal CPAP.

So I think there will not be a bilevel SiPAP as SiPAP already has two pressure levels in its design.

...find any article..

Here are two journal articles where you may find more information

Non-invasive respiratory support of preterm neonates with respiratory distress: continuous positive airway pressure and nasal intermittent positive pressure ventilation.

Davis PG, Morley CJ, Owen LS.

Semin Fetal Neonatal Med. 2009 Feb;14(1):14-20. Epub 2008 Oct 4.

LINK

Neonatal nasal intermittent positive pressure ventilation: a survey of practice in England.

Owen LS, Morley CJ, Davis PG.

Arch Dis Child Fetal Neonatal Ed. 2008 Mar;93(2):F148-50. Epub 2007 Sep 17.

LINK

Edited October 2, 2009 by JACK

[ctestolin]

Dear Jack

I agree with you but in many articles I can find setting similar to a nasal-SIPPV rather than a bilevel CPAP (i.e. we use to set a Ti of 1 - 1,5 sec with rate of 15 per minutes; in all the article I found I always find setting as SIPPV.

In the forum about SIPAP there are setting as Bilevel. That's why I am concerned about SIPAP