1. ) CPAPs
(Continuous Positive Air
Pressure)
For Premature Infants

2. Outline
 Aim & objective
 Introduction
 History
 Physiology of Respiration
 Method & Material
 Other Ideas
 Failures of CPAPs
 Cost Evaluation
 References

3. Aims & Objective
 To reduce the cost
 User friendly
 Simplicity
 Minimizing the power consumption by giving
power other then electrical source

4. Introduction
CPAP (continuous positive airway pressure) is the;
 Mechanical mean to deliver positive air pressure
 Delivered by nasal prong or face mask
 Non-invasive technique
 Pt. breathes through mask against a continuous
positive a/w pressure
 Can be delivered by either volume or pressure
controlled ventilator
 Delivers set pressure with each breath,
maintained throughout the respiratory cycle

5. Introduction(cont’d)
CPAPs are used;
 For patients with breathing problems
 In case of sleep apnea
 Babies with immature lungs/ babies
 To maintain O2 concentration in blood
mostly in premature babies
 To Prevents alveolar collapse during
exhalation by maintaining a positive intra-
alveolar pressure

6. Historical Background
 Von Reuss,German article,the disease of New
born
 1914, basic design of CPAPs
 First successful CPAP device, 1971
 Dr. George Gregory(University of California,
San Francisco)
 Prof.C.Sullivan (Royal Prince Alfred
Hospital, Sydney, Australia,1981)

7. Physiology of Respiratory System

8. Breathing Mechanism

9. Breathing Mechanism (cont’d)

10. Graphical Representation Of Respiration

11. Methods & Materials
 Power source (other then electrical)
 DC Motor (to generate air flow)
 Air flow sensor( check air flow in cm
H2O)
 Nasal prong (to attach with patient)
 Beaker with water & a graduated scale(in
cm H2O) to control pressure according to
lungs volume

12. Basic Flow Diagram
Methods & Materials(cont’d)
Power
Source
DC
motor/
Fan
Pressure r
sensor
Flow
sensor
circuit
O/P To
Patient

13. Methods & Materials (cont’d)
Power source
 Solar Power (solar cells)
photovoltaic effect (e transferred b/w d/f bands)
 Manual Power
using dynamo
using wheel
using injection

14. Methods & Materials (cont’d)
DC motor/fan
12 volts

15. Methods & Materials (cont’d)
Pressure sensor
 convert air pressure into the
voltage
 o/p voltage is directly prop. to
the applied pressure

16. Pressure ranges according to their Use:
Low Pressure
2-3 cmH2O
 Maintenance of lungVolume in very low birth weight
infants
 During weaning
Medium Pressure
4-7 cmH2O
 Increasing lung volume in surfactant deficiency
 Stabilizing areas of Atelectasis
 Stabilizing obstructive airway
High pressure
8-10 cmH2O
 Preventing lungs Collapse with poor lung volume
 Improving distribution of ventilation
Ultra High
11-14 cmH2O
 Tracheal or bronchial collapse
 In severe obstruction
 Reestablishing lung volume during ECHO

17. Methods & Materials (cont’d)
Flow sensor circuit

18. Methods & Materials (cont’d)
 O/P to Patient
 Deliver supplemental
airflow

19. Other Ideas
A simple way to charge the battery is by using
a small dynamo, turned by the DC Fan motor
through a belt.

20. Failure Of CPAPs therapy in RDS
 Very low birth wt. infants
 Late application of CPAP
 Severity of RDS
 Associated disease e.g, sepsis, hypotension
 Infants with severe degree of extrapulmonary
shunt

21. CPAPs in apnea of prematurity
 Decrease the incidence of apnea of prematurity
(compared to other forms of stimulation)
 Improve oxygenation
 Stimulation or inhibition of pulmonary reflexes
 Alveolar stabilization
 Mechanical splinting of airway; reduce
 Supraglottic resistance in both inspiration and
expiration
 Some investigators recommended the early
use of CPAP as a preventive measure of apnea of
prematurity

22. Adverse effect of CPAP
 Pulmonary air leak
 Type of CPAP
 Lung compliance
 Gestational age
 Gastric dilation and rupture
 Hypotension
 Increase pulmonary vascular resistance
 Chronic lung disease

23. Cost Evaluation
Component Price in AUD$
DC Motor ~16.00$
Solar Panel ~40.00$
Rechargeable Battery ~ 25.00$
Tubing Giving by the hospital
Nasal Prongs Giving by the hospital
Flow Sensor ~34.00$
Air Detector Circuit ~12.00$
Other cost ~30.00$

24. Future prospects
 Research work almost have done
 Aware with basic anatomy & physiology
 Hardware will have to be implement
 Can do with some other new ideas

25. References
 Anonymous(21st Nov 2002) , “Obstetric Nursing”
Avaliable:http://academic.cuesta.edu/atorrey/neo~comp.
pdf
 Robert M. Ward*, Joanna C. Beach. (April 2003). “An
International Journal of Obstetrics in Gynecology”
pp8-16.
Avaliable:http://onlinelibrary.wiley.com/doi/10.1046/j.1
471-0528.2003.00012.x/pdf
 Cheryl Morssette (7th June 2010), “CPAP”.
Avaliable:http://preemies.about.com/od/glossaryintheni
cu/g/CPAP.htm
 Anonymous (2006), “Sleep Disorders”, SA, Australia.
Avaliable:http://www.sleepoz.org.au/files/fact_sheets/A
T10%20-%20CPAP.pdf

26. References
 Anne Waugh, Allison Wynn Grant, Janet S. Ross. “Human
Anatomy and Physiology in Health and Illness”, 9th Edition ,
Churchill Livingstone (15 July, 2001)
 Carol Dezateux* and Janet Stocks (2004) Vol. 63, “Lung
development and early origins of childhood respiratory illness”
Avaliable:http://bmb.oxfordjournals.org/content/53/1/40.full.pdf
 Sullivan C. E, Issa F,Berthon-Jones M and Eves L.(1981)”
Reversal of obstructive sleep apnea by continuous positive airway
pressure applied through the nares”
 Available:
http://www.ncbi.nlm.nih.gov/pubmed/6112294?dopt=Abstract
 Dr.J.Rogers,(1999)”Cardiovasculor Physiology”
 Available:
http://www.nda.ox.ac.uk/wfsa/html/u10/u1002_01.htm