663 - Performance Evaluation of a Nonelectric Bubble CPAP System Compared to Electric Bubble CPAP Devices in Neonatal and Infant Lung Models

Publication Number: 3642.663

Alanis Santiago Comas, Vayu Global Health Innovations, Public Benefit Corporation, Boston, MA, United States; Ellie Ng, Vayu Global Health Innovations, Public Benefit Corporations, Medford, MA, United States; Michelle Dundek, Vayu Global Health Innovations, Medford, MA, United States; Kezia D. Asare, Vayu Global Health Innovations, Public Benefit Corporation, Med, MA, United States; Thomas F. Burke, Harvard Medical School, Medford, MA, United States

Background: Continuous positive airway pressure (CPAP) is an important tool for managing respiratory distress in neonates and infants. Minimizing imposed work of breathing (iWOB) and delivering accurate mean airway pressures (MAP) are desirable.

Objective: To compare the iWOB of a nonelectric bCPAP system to two electric systems and to verify MAP accuracy across preterm, term, and small infant lung models.

Design/Methods: Three nonelectric Vayu bCPAP units (Vayu Global Health Innovations, Public Benefit Corporation) and one unit each of electric Pumani and Fisher & Paykel bCPAP systems were tested at Seattle Children’s Research Institute using an ASL 5000 lung simulator with 3D-printed airway models representing preterm (1 kg), term (4 kg), and small infant (10 kg) patients, each paired with corresponding simulated breathing patterns. CPAP pressures of 4, 6, 8, and 10 cmH₂O and bias flows of 5, 8, and 10 LPM were applied. Patient inspiratory iWOB and MAP recorded over 40 breaths for each combination of settings. Mean values were compared across devices using two-tailed paired t-tests (α < 0.05).

Results: The nonelectric bCPAP delivered MAP within 1 cmH₂O of the set value across all pressures, flows, and lung models, compared to deviations of 2.02 cmH₂O and 2.61 cmH₂O for the two electric bCPAP systems. In the preterm model, iWOB imposed by the nonelectric device was lower than both electric devices (p = 1.02E-08 and p = 7.53E-09). In the term model, iWOB was lower than one electric device (p = 0.0010) but higher than the other (p < 0.05). In the small infant model, iWOB was lower than one electric device (p = 3.30E-06) and comparable to the other (p = 0.478).

Conclusion(s): The nonelectric bCPAP system provides accurate MAPs and the iWOB is comparable to or lower than electric bCPAP systems across most preterm, term, and small infant lung models. These findings support the performance of the nonelectric bCPAP system for neonatal and infant respiratory support in clinical settings.