Analýza proudění ventilační směsi novorozeneckými resuscitačními systémy typu rPAP a T-piece

Abstract

During stabilisation and resuscitation of the newborn, it is important to assure sufficient humidification and warming of the ventilation mixture to achieve the correct normothermic level. In clinical practice, two types of resuscitation systems are currently used — the rPAP and the so-called T-piece system. The aim of this study was to analyse the flow of the ventilation mixture through newborn resuscitation systems of the rPAP and T-piece type and to analyse the progress of the temperatures and humidity of the ventilation mixture. The main finding of the work is the identification of the ambient air admixture phenomenon in the rPAP generator, which represents about 30% increase in flow rate compared to the set value. When analysing the progress of the temperature and humidity of the ventilation mixture, it was found that there are differences in the required parameter. The temperature of the mixture in the rPAP system is on average 25,7 °C and the relative humidity is 40 %. When the ambient air entrainment phenomenon was eliminated in the rPAP system, the temperature was statistically significantly higher from the 8th minute after system start-up, and the humidity was statistically significantly higher from the 2nd minute after system start-up. This paper compares the effect of the set inlet flow rate at the outlet of the tube towards the newborn for the T-piece and rPAP systems. In the case of rPAP, the flow of the open and closed structure of the ventilation applicator is examined more closely. When adherence is avoided, the results are similar to the T-piece system for a temperature in an average difference of 2 °C lower, and the humidity matches. The air entrainment phenomenon was confirmed by SW simulation.