Understanding Appropriate CPAP Pressures for Premature Infants
Our little girl, born at just 25 weeks, spent 75 days on a ventilator. Initially, she was placed on a jet ventilator before transitioning to a traditional one. Just last week, we attempted to extubate her, but unfortunately, that effort lasted less than four hours before we had to revert back to ventilation. Currently, she is receiving CPAP via nasal cannula, which is connected to the ventilator. The peak inspiratory pressure (PIP) has been set to 15, which seems excessively high as it appears that the air is forcing itself out of her nose with each breath. Is this level of pressure standard? How can a tiny baby manage to breathe under such conditions? One of the nurses mentioned that it resembles trying to breathe while sticking your head out of a moving vehicle on the highway. This analogy really puts into perspective the challenge our daughter faces with her current settings.
Answers (1)
9/2/2025, 1:40:43 AM
OpenHealth AI
I understand that you are concerned about your daughter's current CPAP settings, especially given her history and the challenges she has faced since her premature birth. It's completely normal to feel worried, and you are right to seek clarity.
Main Points:
- CPAP pressures can vary, and finding the right level is crucial for your infant's comfort and breathing effectiveness.
- A PIP of 15 cm H2O may be on the higher side for some infants, and it’s important to monitor her response to this pressure.
Explanation: Continuous Positive Airway Pressure (CPAP) is used to help maintain open airways and support breathing without the need for invasive ventilation. The appropriate pressure setting can vary based on the infant's age, size, and specific respiratory needs. In preterm infants, pressures usually range from 5 to 12 cm H2O; however, some may temporarily require higher settings during respiratory distress.
Your daughter's high PIP of 15 could be a necessary adjustment depending on her current respiratory health and specific parameters set by her healthcare team. The analogy you shared about breathing with your head out of a moving vehicle illustrates why the right balance of pressure is essential – excessive pressure might lead to discomfort and difficulty for her.
Next Steps:
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Monitor Clearly: Observe how she is responding to the CPAP. Look for signs of distress such as increased heart rate, agitation, or changes in her color.
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Discuss with the Healthcare Team: Communicate your observations and concerns with your healthcare team. Ask them to explain the rationale behind the current PIP setting and whether adjustments might be beneficial for her comfort and effectiveness of breathing support.
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Inquire About Adjustments: If the pressure seems excessively high or if she appears uncomfortable, inquire whether a gradual reduction could be attempted. Continuous reassessment is key.
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Request a Comprehensive Plan: Ask if they can provide clarity on her long-term respiratory plan, including potential timelines for extubation and adjusting CPAP pressures to promote her transition to independent breathing.
You are doing a tremendous job advocating for your daughter. It’s essential to stay involved and seek answers from the medical team to feel more informed and supported during this challenging time.
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