Apnea due to prematurity is a common occurrence in the Neonatal ICU. Half of premature babies experience this. As a result of apnea, various negative effects arise, which also trigger many alarms on the patient monitor or ventilator. There are several methods of apnea detection. In this blog, I will discuss apnea detection using an abdominal respiration sensor.
Apnea detection with the abdominal respiration sensor
The abdominal respiration sensor is a small air chamber with a piece of foam incorporated into it. This air chamber is connected via a tube to a very sensitive pressure sensor in the ventilator, which is very capable of detecting respiratory movements, or the absence thereof, through the pressure fluctuations. This sensor is placed abdominally, preferably where the abdominal movement is greatest during the child’s breathing. In practice, the sensor is sometimes simply placed between the diaper and the abdomen.
Back-up ventilation
By using the respiration sensor during nasal CPAP in the newborn, the ventilator can detect spontaneous respiratory movements. The moment the patient experiences apnea, the respiratory movement will be absent, and the device will notice this. Now an apnea alarm can be given, but above all: back-up ventilation can be started. In this way, we can enable the ventilator to apply (non-invasive) breaths when apnea occurs. We can counteract many negative effects of apnea as early as possible in this way. In any case, the patient remains directly respiratory supported, even during apnea. The ventilator indicates how often the apnea system has been activated.
What are the benefits?
The ventilator automatically intervenes before a healthcare provider is with the patient. In this way, you counteract negative effects of apnea as quickly as possible and also prevent many alarms. Instead of direct alarming on apnea, it is now more important to keep an eye on the apnea counter. The moment the child has spontaneous breaths again, the device will reduce the back-up ventilation. There is a very elegant function for this, called “Frequency Back-up”, where the device will reduce the back-up ventilation in several steps for a smoother transition to full spontaneous breathing.
Apnea detection and related back-up ventilation can therefore absolutely be an enrichment. Both for the patient and for the healthcare provider.
