RDS Therapies

Nasal continuous positive airway pressure (nCPAP)

Due to a lack of surfactant in RDS, alveoli tend to collapse easily and the atelectatic areas of the lung are unavailable for gas exchange. Maintaining a continuous positive pressure throughout the respiratory cycle can prevent this collapse. This increases functional residual capacity and ventilation of the perfused areas improves.

nCPAP is used in infants who require 30-40% oxygen to maintain adequate oxygenation. Nasal prongs are inserted into the nostrils and connected to a lightweight ventilator circuit. The prongs are kept in place by either a soft cord or bonnet and tapes.

Gas is then continuously blown into the lungs at a constant pressure of 4-9 cmH2O. At the end of expiration there is a slightly positive pressure holding the alveoli open.

Care must be taken to avoid trauma to the nostrils.

High Frequency Oscillation Ventilation (HFOV)

High frequency ventilation involves the delivery of gas at a constant pressure which is then oscillated at a frequency of 10Hz (~ 600 oscillations per minute) thus producting ventilation with small tidal volumes.
HFOV can improve blood gases though the exact mechanisms are unknown.
During HFOV both inspiration and expiration are active.