Brand of nasal prongs/mask used for CPAP

TiffyRN, BSN, PhD · Jul 6, 2011

What brand do you use..Hudson/FisherPaykel ??????
Mask or Prongs or alternate?
Anything used to prevent damage to nasal septum?
Special nursing care?
How do you wean OFF CPAP?
Anyone using Bubble CPAP?
Any tips/recommendations?
I would like to contact someone working at Columbia Mothers & Babies New York re their use of nasal CPAP.......any suggestions how I might do this?
Thanks
Lynda

1. Hudson

2. Prongs

3. Frequent monitoring, and many measures to avoid allowing the prongs to rest on the septum.

4. Constant monitoring for bubbling, very frequent monitoring for positioning of prongs, really much more than this, but keeping it short.

5. Weaning is done by "cycling" off to RA for so many hours off CPAP then so many hours back on CPAP. The trials of course are terminated for new or worsened tachypnea, increased WOB, new or increased A's+ B's. If the infant had been on 21% and repeatedly fails at cycling to RA the MD's concede and place the infant on a blended high flow cannula (usually 4L/min) or Vapotherm at flow rates as high as 8L/min. If the infant has been requiring > 21%, then the infant might cycle on and off of a high flow cannula or might just be placed on that HFNC.

6. Yes, we use BCPAP 99% of the time unless it is felt the infant could benefit from CPAP with a rate which requires the same nasal prong set-up but it connected to a ventilator. That is usually only if the infant is having A's + B's on BCPAP, but most of the time, those infants just need to be intubated (IMO).

As for tips and suggestions, I believe you already on to the best one which is to talk with the people at Columbia. I'm sorry, but I don't know how to do this.

NICURN29 · Jul 9, 2011

We use Hudson prongs and protect the septum by using Cannulaides, which are manufactured by Beevers. We usually use bubble CPAP, unless the baby needs a rate or we want to give some pressure support, in which case we used the PB840 ventilator that we use for intubated babies. Weaning depends on what kind of course the baby has had. We don't often alternate CPAP and cannula anymore, instead using high flow nasal cannula as an intermediate step between CPAP and wall cannula. If the baby is just briefly on CPAP for TTN, we usually wean to PEEP of 4 and the go directly to room air once the baby has done well on the lowered PEEP.

I am not sure what you mean by special nursing care. We do check the septum frequently and change the Cannulaide when it is no longer intact. Since our bubble CPAP doesn't have an alarm on it, we monitor the bubbling in our receptacle to make sure that the baby is getting the pressure.

We do infrequently put babies on SiPAP with a mask if they are having bad breakdown of their septums, but this doesn't happen often.