Chandler

Using the Neo-Tee® to deliver CPAP and/or PPV in the delivery room We have found the Neo-Tee® to be the very best device to safely deliver CPAP and/or PPV in the delivery room setting, period. We routinely give CPAP using the Neo-Tee® for all cesarean section births to promote alveolar stability and enhance alveolar recruitment (volume). As a matter of fact, we have the Neo-Tee® available for all births for immediate implementation whenever CPAP is needed. The application of the Neo-Tee® mask CPAP usually lasts for only a few breaths, but it makes all the difference in the world and allows for the baby to be transferred to the LDRP rather than the NICU. The successful transition from fetal circulation to pulmonary circulation depends in large part, on the neonate’s ability to achieve a stable functional residual capacity (FRC) immediately following birth. This challenge is made more difficult following a cesarean section birth where the neonate does not have the benefit of the normal birth mechanics and the resulting reduced work of breathing during the important first few breaths. That is when the neonate attempts to establish their FRC. The challenge in these neonates is to achieve and maintain an adequate FRC, thus allowing alveolar stability and optimizing alveolar volume or recruitment. Achieving alveolar stability means that the neonates first few spontaneous breaths must be efficient enough to achieve and maintain an adequate alveolar volume. Otherwise, transition to a normal pulmonary circulation will never be accomplished. Maintaining alveolar stability also means that there is adequate end expiratory alveolar volume to prevent alveolar collapse and loss of alveolar recruitment or volume. The only strategy that has proven to promote alveolar stability and enhance alveolar recruitment (volume) in the delivery room and the NICU is CPAP in one form or another. Chandler