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Non-invasive support modalities utilize different applications and mechanisms but share similar physiologic mechanisms of support.
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All modes assist care givers in avoiding mechanical ventilation and the associated injuries to the lungs and airways.
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None of the modalities can achieve the ideal goal of being the right therapy for all patients across the age and disease spectrum treated in the newborn intensive care unit setting.
Physiologic Basis for Nasal Continuous Positive Airway Pressure, Heated and Humidified High-Flow Nasal Cannula, and Nasal Ventilation
Section snippets
Key points
Prevention of Mucosal Injury
A crucial function of noninvasive support modalities is their ability to condition the respiratory gases, by both warming to near body temperature, and humidifying the gas mixtures. Without this proper conditioning, patient discomfort and nasal mucosal injury, as well as pharyngeal and lower airway injury, are well described.
Early in the attempts to provide supplemental support to patients with respiratory distress, it became clear that appropriate conditioning was crucial for maintaining
Summary
All 3 modalities that provide noninvasive support have demonstrated value for clinicians treating both preterm and term infants with a wide variety of pathophysiologies leading to respiratory distress and apnea. Whether the device is a pressure-regulated system using flow to generate pressures delivered at the nasopharynx or simple flow delivery systems to the nasopharynx, the mechanisms leading to improvement are similar across the modalities. The ability to support the inspiratory work of
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