HMFW Bubble CPAP System Improves Outcomes for Premature Babies|
FORT WORTH, Texas – Bubbles have entertained kids for generations. Now they are helping improve the care of premature infants. The Harris Methodist Fort Worth Hospital (HMFW) neonatal intensive care unit recently implemented the use of the Bubble CPAP – a breathing assistance system showing promising results in decreasing the incidence of chronic lung disease among premature infants. HMFW was the first to implement the system and is one of only two hospitals in the Metroplex currently using Bubble CPAP.
Babies born prematurely often have underdeveloped lungs. Continuous positive airway pressure, or CPAP, is a breathing system commonly used to deliver airflow and pressure to an infant’s lungs via short prongs in the nose. This air pressure helps to keep the lungs open at the end of exhalation while allowing the baby to initiate his/her own breathing.
But a simple twist in this system – the addition of bubbles – is proving more effective in helping infants breathe on their own and decreasing the need to put some babies on mechanical ventilators.
How it Works
Bubble CPAP creates this pressure by placing the expiratory tube in a column of liquid. The flow of air into the liquid causes the solution to bubble. This bubbling creates vibrations that are transmitted to the baby’s chest, helping the infant maintain better lung inflation and aiding in the proper movement of gases into and out of the lungs.
“It’s a very simple approach,” said Randy Grubbs, M.D., a neonatologist on the medical staff at HMFW, “but I think it will ultimately become the best practice for NICUs nationwide when it comes to improving the lung development of premature babies.”
Why HMFW Chose Bubble CPAP
The decision to implement the Bubble CPAP system came after a year-long review of clinical research demonstrating the system improves outcomes more effectively than others.
“This implementation was completely evidence-based,” Dr. Grubbs said. “We reviewed the medical research literature thoroughly and modeled our process after NewYork-Presbyterian Hospital/Columbia University Medical Center, which reports the lowest rate of chronic lung disease in the world – six percent compared to the national average of 24 to 30 percent.”
Chronic lung disease remains one of the most common and debilitating outcomes for very low birth weight premature infants and is the result of permanent alteration of lung development associated with the use of mechanical ventilators.
“Although infant ventilators have become increasingly sophisticated over the past several years, and are certainly necessary in many instances to save babies’ lives, they remain one of the major factors associated with developing chronic lung disease.”
Chronic lung disease leads to increased susceptibility and severity of respiratory infections and asthma and has been associated with neurologic and developmental setbacks, according to Dr. Grubbs. In addition, the invasive process of placing a breathing tube into the trachea and breathing with the aid of a ventilator carries risks such as vocal cord or airway injury, ventilator-associated pneumonia and infection.
“I think the Bubble CPAP also has the benefit of being very parent friendly,” said Pam White, NICU clinical nurse educator. “It is very easy to let a parent hold an infant with Bubble CPAP. If the nose prongs fall out while being held, they easily slip back in, unlike when a baby is accidentally extubated if the ventilator tube is dislodged.”
Nurses Key to System’s Success
“Patient-focused care and continuous quality improvement are the hallmarks of a Magnet hospital, which we are. So it’s no surprise to me that our staff embraced this system when they saw the evidence of its quality.”
For more information about neonatal intensive care services at HMFW, log on to www.TexasHealth.org/HMFW or call 817-250-BABY.
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