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An improved Bussignac device for the delivery of noninvasive continuous positive airway pressure: the SUPER-Bussignac

Introduction

The purpose of this work was to test, in a bench study, the performance of a modified Boussignac continuous positive airway pressure (CPAP) system, aimed at avoiding the drop in inspired oxygen fraction (FiO2) during high inspiratory patient peak flows.

Methods

We modified a Boussignac system (Bssc), inserting between the valve and the face mask a T-piece, connected with a 1.5 l reservoir balloon, supplemented with oxygen independently from the valve itself. During inspiration, the patient inhales oxygen from the reservoir, diminishing the blending with atmospheric air and keeping the FiO2 higher. The performance of the system was evaluated in a bench study, applying a CPAP face mask to a plexiglass cylinder connected with an active lung simulator (ASL 5000; IngMar Medical, USA) generating tidal volumes with increasing inspiratory peak flow rates (V'insp). Two positive end-expiratory pressure (PEEP) levels were tested for the Bssc, SUPER-Boussignac with 10 l/min (SB10) and 30 l/min (SB30) supplementary oxygen flows. The FiO2 was continuously recorded and the lowest value reached during each tidal volume (FiO2) was averaged over 20 breaths.

Results

With all systems the FiO2 increased with increasing PEEP levels and decreased at higher V'insp. SB10 and, to a greater extent, SB30 allowed one to reach greater FiO2 values, and decreased the drop in FiO2 due to increasing V'insp. See Tables 1 and 2.

Table 1 FiO2 values at PEEP 7 cmH2O
Table 2 FiO2 values at PEEP 13 cmH2O

Conclusion

The SUPER-Boussignac is simple and effective in increasing (up to 30%) the FiO2, and limiting the drop related to V'insp during noninvasive CPAP.

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Bellani, G., Foti, G., Spagnolli, E. et al. An improved Bussignac device for the delivery of noninvasive continuous positive airway pressure: the SUPER-Bussignac. Crit Care 12, P342 (2008). https://doi.org/10.1186/cc6563

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Keywords

  • Continuous Positive Airway Pressure
  • Tidal Volume
  • Peak Flow
  • Face Mask
  • Peep Level