NOISE LEVELS DURING nCPAP

Karam O, Donatiello C, Van Lancker E, et al. Noise levels during nCPAP are flow-dependent but not device-dependent. Arch Dis Child Fetal Neonatal Ed 2008;93:F14-F19 [Full text] [PDF]

Objective. Nasal continuous positive airway pressure (nCPAP) has been shown to improve the outcome of infants with respiratory distress syndrome. However, noise generation could be of concern. Therefore, our study was designed to measure the noise levels of various CPAP drivers.

Methods. For infants admitted to our neonatal intensive care unit and paediatric critical care unit, we measured the noise level in the oral cavity, using a microphonic probe with a flexible capillary tube. Various CPAP drivers and interfaces have been tested.

Results. 27 measurements were made in eight infants. Mean noise level was 88.6 (SD 18.8) dB and was correlated with flow (p,0.01) but not with pressure. A noise level above 90 dB was detected in 67% of the measurements.

Conclusions. nCPAP drivers are valuable devices for neonatal care that may prevent primary mechanical ventilation or re-intubation, but generate a large amount of noise, often higher than occupational limits accepted for adult workers. Therefore, new devices must be designed to minimise this possible noxious exposure of premature infants to unacceptably high noise levels.

Comments. Small study, big noise! The authors finding that preterm infants on nCPAP are exposed to higher noise levels than what is considered acceptable for adults by occupational standards is concerning. Although nothing is known about the possible consequences of such - often prolonged - noise exposure, I agree with the authors that these noise levels are unacceptably high and manufacturers of CPAP devices should focus on developing quieter machines in the future. TMB

Editor’s Comment: The noise levels recorded in this study were produced by stand-alone CPAP drivers (Arabella, Infant Flow, and F15 MediJet). I had no idea that these devices were so noisy, so I held one to my ear – WOW! I would be curious to know how this compares to the noise level produced by ventilator CPAP or Bubble CPAP. ABK

You may add your own comments to the discussion of this topic by selecting : Submit Comments.