Nasal Continuous Positive Airway Pressure, or nCPAP, is a widely used method for supporting infant breathing. This non-invasive respiratory aid delivers a gentle, steady flow of air pressure through the baby’s nose to assist their breathing efforts without requiring more intrusive interventions.
Understanding nCPAP
nCPAP stands for nasal Continuous Positive Airway Pressure, a therapy that provides constant gentle pressure to an infant’s airways. Its primary goal is to keep the air passages open, making it easier for the baby to breathe. The system typically consists of a flow generator that produces the air, a humidifier to warm and moisten the air to prevent irritation, and an interface that delivers the pressure to the baby.
The interface usually involves small nasal prongs placed just inside the nostrils or a tiny mask that covers the nose. This setup ensures the continuous positive pressure reaches the baby’s delicate respiratory system effectively.
How nCPAP Supports Infant Breathing
The continuous positive pressure delivered by nCPAP works by gently inflating the infant’s tiny airways and microscopic air sacs, known as alveoli. This constant pressure prevents these structures from collapsing completely at the end of each exhalation, a common challenge for infants with underdeveloped lungs. By keeping the airways open, the baby expends less energy to re-inflate their lungs with each breath.
This sustained openness reduces the infant’s work of breathing, allowing them to conserve energy for growth and development. It also improves the exchange of oxygen into the bloodstream and carbon dioxide out of the body, optimizing gas exchange. Maintaining a consistent lung volume helps prevent lung injury from repeated collapse and re-expansion. Unlike mechanical ventilation, which takes over breathing entirely, nCPAP supports the baby’s natural breathing rhythm and efforts.
When nCPAP is Used
nCPAP is frequently employed for several conditions affecting infant respiration. It is a primary intervention for Respiratory Distress Syndrome (RDS) in preterm infants, where their lungs lack sufficient surfactant, a substance that helps keep air sacs open. nCPAP also addresses apnea of prematurity, a condition where premature infants temporarily stop breathing due to an immature nervous system.
nCPAP serves as a supportive therapy after infants are removed from mechanical ventilation, a process known as extubation. It acts as a bridge, helping them transition back to independent breathing while providing ongoing support to prevent respiratory failure. In some cases, nCPAP is used to prevent the need for intubation and mechanical ventilation altogether, offering a less invasive alternative for infants experiencing moderate respiratory difficulties.
Managing Care with nCPAP
Maintaining a proper fit for the nasal interface, whether prongs or a mask, is important to prevent skin irritation or breakdown on the delicate skin around the nose. Regular checks and adjustments ensure the interface is secure but not overly tight.
Monitoring for potential issues like abdominal distension is a routine part of care. This can occur if some of the positive pressure air enters the stomach instead of the lungs. If abdominal distension becomes significant, gastric decompression, often achieved by inserting a small feeding tube to release air, may be necessary. Feeding strategies may need adjustment, with gavage feeding (delivering milk through a tube directly to the stomach) being common, as sucking and swallowing can be challenging while on nCPAP. As an infant’s respiratory function matures and improves, healthcare providers gradually reduce the nCPAP pressure in a process called weaning, eventually transitioning the baby off the support entirely.