Tiny Breath of Fresh Air

A kinder, gentler way to care for babies with respiratory distress syndrome…

Dr. Steven Gwiazdowski

In the high-tech world of the Neonatal Intensive Care Unit (NICU), a simple and innovative procedure has babies breathing easier and avoiding the complications that can arise from spending time on a ventilator.

“In a sense we’ve stepped back in time to a procedure used at New York’s Columbia University NICU since 1973,” says Neonatologist Steven Gwiazdowski, M.D., who spearheaded the drive to bring the breathing system, called Bubble CPAP (Continuous Positive Air Pressure), to NorthBay Medical Center.

Dr. Gwiazdowski traveled to New York 18 months ago to observe how Bubble CPAP is used at Columbia University Medical Center. He returned to Fairfield convinced that the system would work in NorthBay’s NICU. A multidisciplinary team consisting of nurses, respiratory therapists, pharmacists and central supply worked for a year to analyze the system and train staff to implement it. On Feb. 1, the NICU seamlessly rolled out the Bubble CPAP procedure and they’re very impressed by the effectiveness of it, according to Dr. Gwiazdowski.

Traditionally, babies with premature lungs are placed on ventilators. Ventilators have a tube that passes through the vocal cords into the airway, efficiently breathing for the baby. However, the ventilator can be a source of inflammation because the ventilator can’t completely adjust to the natural way a baby breathes. And, ventilators can be a source of infection.

A ventilator tube isn’t used with Bubble CPAP. Instead, air pressure is transmitted from the nose, and the baby’s own breathing regulates how high the pressure needs to be. The key to regulating air pressure in the lungs is controlling the exhaled breath. With Bubble CPAP, the end of the tube carrying the baby’s exhaled breath is submersed in water. The depth of the tube in the water determines the air pressure in the lungs. As the baby exhales, bubbles are created, which cause vibrations that travel back into the lungs. It’s speculated that these vibrations stimulate the tiny air sacs in the lungs to expand and contract, helping the lungs to breathe.

Bubble CPAP can be easily monitored by the bedside nurse. And, without their baby attached to a ventilator, parents find holding and feeding their baby much easier.

“This is a kinder, gentler way to care for babies with respiratory distress syndrome,” says Dr. Gwiazdowski. “Bubble CPAP keeps lungs inflated and allows babies to breathe with a lot less work.”

While there will always be a need for ventilators in the NICU, the staff hopes that Bubble CPAP will mean less time spent on a ventilator for many babies, helping their lungs get a healthy head start.

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