SiPAP

I wonder if it is like SNIPPV?

Oh, if only Vapotherm were still around!!!!

Is anyone else using the Fisher Paykel version? It's a high flow, heated, humidified cannula system just like Vapotherm. Basically they just took one of the heater/humidifiers they use on ventilators and attached it to the wall air/oxygen flow. The highest we can go off the wall normally is 2 liters because even though it's humidified, it's not heated. But with this system we can go up to 7 or 8 liters of airflow, just as high as with Vapotherm. The week after Vapotherm was recalled, we started using Fisher Paykel and it works just as well. The babies are doing just as well on it, and it seems to deliver the same product, just in a different package.

The only things we don't like are the fact that the tubing is much shorter (it's actual vent tubing attached to a cannula, rather than that nice long flexible tubing that Vapotherm had) and it doesn't have a disconnect alarm so you really have to check your baby often.

We do NIMV (Nasal SIMV) Is it like that? It has prongs like CPAP.

We use SiPAP (as well as NCPAP) here. The SiPAP basically gives an extra "burst of air" to the babies with a set rate. A baby on CPAP would be on something like +5 or +6... the 5/6 being the PEEP. When they're on SiPAP, they would be on a setting like: Rate of 15, 15/6. They are always getting the PEEP of +6, but then on a rate of 15bpm, they get a PIP of 15. It's great for some of these chronic kids who simply don't have a lot of energy and poop out quickly after being extubated. The extra support helps keep them from being reintubated a lot of the times.

We also use the Fisher-Pykel heaters for high flow nasal cannulas - but ours only go up to 4lpm..... I wonder if we could go higher??? Gotta miss Vapotherm...

Is anyone else using the Fisher Paykel version? It's a high flow, heated, humidified cannula system just like Vapotherm. Basically they just took one of the heater/humidifiers they use on ventilators and attached it to the wall air/oxygen flow. The highest we can go off the wall normally is 2 liters because even though it's humidified, it's not heated. But with this system we can go up to 7 or 8 liters of airflow, just as high as with Vapotherm. The week after Vapotherm was recalled, we started using Fisher Paykel and it works just as well. The babies are doing just as well on it, and it seems to deliver the same product, just in a different package.

The only things we don't like are the fact that the tubing is much shorter (it's actual vent tubing attached to a cannula, rather than that nice long flexible tubing that Vapotherm had) and it doesn't have a disconnect alarm so you really have to check your baby often.

Our unit uses the FP high flow and the babies are doing well on it!

we also have been using the FP highflow. One of the RT's said all you needed was something to humidify and soemthing for flow. I see us using the sipap a lot more on the microtots who ahve been extubated. It is amazing to see 24-25 weekers on sipap!! If onyl some of our kids could stay on it!

do you all use the short prongs or the nose cover (dont know what it is called) We alternate wbnetween the two to prevent breakdown, but I really like the trianlge cover better.

we also have been using the FP highflow. One of the RT's said all you needed was something to humidify and soemthing for flow. I see us using the sipap a lot more on the microtots who ahve been extubated. It is amazing to see 24-25 weekers on sipap!! If onyl some of our kids could stay on it!

do you all use the short prongs or the nose cover (dont know what it is called) We alternate wbnetween the two to prevent breakdown, but I really like the trianlge cover better.

Well, you do need more than humidity and flow - the key to these systems is the heater. For years we've been giving kids up to 2 LPM airflow off the wall with oxygen blended in to keep sats within range - we had the flow and we had a bubbler attached for humidity. But you can't go over 2 LPM and most preemies need more than that, especially right after extubation or surfactant administration. By adding in a heater, you end up with body-temperature vapor in the tubing, which enables you to not only give high flow without chilling the babies, but also protects the airway from damage which can occur when flow is given at lower temperatures.

We don't use the nose masks at all - we just use regular nasal cannula tubing that is about a foot long (two sizes - preemie and newborn) attached to the FPNC vent tubing. True, it doesn't provide a seal and some air will leak out around the cannula prongs, but we follow the babies clinically and increase our flows to support them that way.

When I was on orientation we had a baby on SiPap. I remember my preceptor saying she was glad we had that baby because they were going to be doing away with the SiPap and she wanted me to at least see it. Not sure why they were doing away with it, as it sounds like it works well for everyone.

I know there are different kinds of NCPAP we use. Sometimes they're on a NCPAP that is hooked up to the SIMV machine ...... and they can set it with a rate and some other stuff (not sure about all the respiratory stuff yet). If they're on NCPAP on an Aladdin they can't have a rate.

Not even sure if I'm making much sense here, lol ..... I'm still new to all this.

I've seen you guys talk about Vapotherm before and this thread has answered my questions as to what it was. But why was it recalled? And are they planning on bringing it back?

I've seen you guys talk about Vapotherm before and this thread has answered my questions as to what it was. But why was it recalled? And are they planning on bringing it back?

It was an infection control issue. If I remember correctly, the cartridges they used to run the water through (I think that's where the water was heated into vapor) weren't disposable and there was colonization of bacteria (Ralstonia) found in many of them that was causing nosocomial infections in hospitalized patients. They are currently working on new ways to disinfect the units before they can be used again - though it looks like they are still approved for use in other countries besides the US at this time.

It was a voluntary recall - for example, if a patient had it for home use (sleep apnea, tracheomalasia, etc.) they could decide if they wanted to send it back or not since they had much less of a chance for infection since they owned the actual unit.

There is a press release about it on their website:

Vapotherm :: About Us :: News