PAPmate: Augmenting Minimally Invasive Respiratory Support of Neonates
Program: Biomedical Engineering
In Neonatal Intensive Care Units (NICUs), 15% of term infants and 29% of late preterm infants develop significant respiratory morbidity. Minimally invasive respiratory support systems are used to alleviate respiratory distress syndrome (RDS) and support healthy lung development in spontaneously breathing neonates. Bubble CPAP (bCPAP) is one such support system, utilizing turbulent flow to inflate fine alveolar folds. However, the failure rate of bCPAP varies between 35 and 50%. Stakeholder interviews indicate that this high percentage is due to frequent nasal interface disconnections, which go unnoticed between periodic check-ins. The resulting pressure loss reduces respiratory drive stimulation, leading to hypoxia-related complications and loss of lung inflation. This may require escalation to intubation and mechanical ventilation, increasing risk of arrested lung development, lung damage, and chronic lung disease. Thus, there is a need to provide more robust minimally invasive respiratory support to neonates experiencing RDS to reduce the number of days intubated on mechanical ventilation.
Our solution is a two-in-one system that reduces the frequency of disconnections at the nasal interface while improving disconnection detection. The first component is an adjustable nasal interface with conical prongs to improve grip in the nares and an adjustable centerpiece to increase comfort around the septum. The second component is a monitor that measures bubbling within the bCPAP canister, as the presence of bubbling indicates the nares are completely occluded by the prongs. When bubbling ceases due to a disconnection, the monitor will alarm to notify NICU staff.
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