A full 60% of the infants born after 28 weeks of pregnancy or less are prone to respiratory distress syndrome (RDS). The lungs of these infants are underdeveloped, and the required gas exchange cannot take place. Hence their breathing needs external support. NCPAP 300 is a simple continuous positive airway pressure (CPAP) system designed to provide support to fragile infants suffering from RDS. NCPAP 300 prevents airway closure and maintains the functional residual capacity. It has been ergonomically designed and is remarkably easy to operate.

1. CPAP

2. Before the baby is born, the lungs are collapsed and oxygen is provided to the baby through the placenta. The placenta allows
the passage of oxygen and nutrients from the mother’s blood to the baby’s blood via the umbilical cord.
After the baby is born this all changes. When the umbilical cord is cut, the lifeline of oxygen enriched placental blood is severed.
Air, hunger begins and the newborn baby will begin to gasp for air. With this gasp the lungs expand for the first time and convert
from a collapsed, solid mass to soft air filled bags.
A Baby's Lungs

3. The lungs are made up of airways that spread out like tree branches from large airways
(bronchi) to smaller airways (bronchioles). At the ends of the airways are the alveoli--tiny
bubbles that do all of the real work in the lungs, exchanging oxygen and carbon dioxide.
How do the lungs help us breathe?

4. Surfactant is to prevent collapse of the alveoli thereby reducing the effort needed to
expand the lungs during inspiration and allow gas exchange to take place. Surfactant
therefore helps breathing to be relatively effortless.
Alveoli and Surfactant
Normal alveoil Collapsed alveoil

5. Preemies need assistance breathing because of the lack of surfactant and alveoli being produced. Preemies airways are much
smaller and more narrow than a term baby, infection will build up and clog them much faster
Preterm Vs Term Baby's Lungs
24 – 35 Weeks Gestational Age 36 Weeks Gestational Age to 3 years of age

6. RDS
• Neonatal RDS occurs in infants whose lungs have not yet fully developed.
• The disease is mainly caused by a lack of a slippery substance in the lungs called surfactant. This substance helps the
lungs fill with air and keeps the air sacs from deflating. Surfactant is present when the lungs are fully developed.
Treatment for RDS
• Breathing support from a nasal continuous positive airway pressure (NCPAP) machine or ventilator
• Surfactant Replacement Therapy
• Oxygen Therapy

7. Continuous Positive Airway Pressure.
• CPAP is a treatment that uses mild air pressure to keep your breathing airways open.
• The positive airway pressure helps to keep the alveoli open during expiration
• Short prongs or a mask are positioned by the nostril or nose
• Humidified air and oxygen mix is blown in at a constant low pressure.
• CPAP keeps the lungs open thus preventing it from collapse.
• CPAP maintains positive pressure in the airway and thereby increases functional residual capacity.
• CPAP does this by stabilizing airspaces so that they don’t collapse during expiration
CPAP working

8. CPAP USP
Versatile
Can be configured for both flow and bubble operation according to the caregiver’s
preference
Digital control
The FiO2 and flow are adjusted easily and accurately using soft-touch keys
Compact electronic blender
The proportions of air and oxygen are precisely controlled so that the safety and
efficacy of therapy are greatly enhanced.
Lightweight patient interface
Intricate design to eliminate damage to the nasal septum and delicate nostrils of the
infant
Universal circuit interface
Compatible with the various circuits available in the market
Safety alarm
Continuous monitoring of oxygen concentration, pressure and apnea, with alerts
provided if these parameters cross set limits. The alarm system ensures safe
administration of CPAP and protection of the infant’s lungs from damage.

9. TYPES OF CPAP
Variable / infant flow driver Constant / bubble
Desired CPAP level is generated
by varying the flow.
Flow is kept constant , pressure is
generated through bubble jar

10. Components
1. Gas source : To provide continuous supply of warm humidified and blended gases i.e. air and oxygen
2. Pressure generator : To create the positive pressure in the circuit
3. CPAP device to patient : To connect the CPAP circuit to the infant's airway.

11. GAS FLOW
► Amount of gas flow varies on device and patient.
► There is mix of oxygen and air through compressor or hospital line outlets.
1. FiO2 Fractional O2 percentage : The fraction of inspired oxygen that is added to the delivered air
(Range – 21% to100% )
2. Gas flow : 5-8 l/min
3. End expiratory pressure : 0 – 15cm H20

12. HUMIDITY
Humidity generated by humidifier prevents water-loss in airway of infants.
Humidity helps the following in infants:
• Prevents pain and discomfort
• Prevents thickened secretions due to water loss.
• Prevents constriction.
• Humidification – Up to 100%
• Ideal Humidifier temperature – 34°C to 37° C

13. BUBBLE CPAP
• Non-invasive ventilation strategy for newborns with infant respiratory distress
syndrome (RDS).
• Bi-nasal prongs are used to deliver blended gases.
• In bubble CPAP breathing tube one end is placed bubble jar. When air passes
“bubbles” are generated in turn creating oscillation. Higher the oscillation
generates higher pressure.
• Pressure is set via bubble jar according to baby requirement .

14. Simple Bubble CPAP Setup and Components

15. INFANT FLOW DRIVER
• Variable CPAP provides effective breathing in infants.
• Flow is varied to get the required pressure
• Work of breathing is comparatively less
• The mechanism is based on fluidic flip. When baby breathes in system inhales, and when baby breathes out there
is fluidic flip for exhalation of gases.

16. CPAP Circuits Assembly ( Flow Driven)

17. Difference
FLOW CPAP BUBBLE CPAP
Also known as Variable flow Also known as Constant flow
Its a open system Its a closed loop system
Baby breaths in synchrony with the device Continuous air supply is provided to baby regardless of its breathing
activity
Flow is varied to achieve the pressure Flow is kept constant and Pressure is set via oscillatory pressure
generated by bubble jar.
WOB is less WOB is higher than flow CPAP

19. Thank you
Phoenix drives to work towards a future where every Newborn has access to
high - quality Medical care
Email : marketing@pmsind.com
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