NIV-SPI
A small nasopharyngeal (suction) catheter (8 Fr.) was inserted via one
(right) nostril to a length of 0.5 cm less than the measured distance
from nose tip to ipsilateral tragus which ensured the tip positioned in
the oropharynx. Then, a heated humidified continuous oxygen flow was
provided through the catheter at rate of 1.0 L/kg/min. So that oxygen
could fill the entire upper airway space (Figure 1), which bearing
similarities to “high flow nasal cannula”. Endoscopist’s index finger
of right hand hooked under the neonate’s chin while both thumb and
mid-finger placed around ala nasi in a pinching position as well as
holding the endoscope at nose. Then, following maneuvers were executed
optionally to deliver PPV:
(1) Inspiration phase was accomplished by nose(mouth)-closure with
pinching thumb, index and mid-finger of right hand. Cricoid pressure
might also be applied concurrently with ipsilateral little finger.
While the SPI with duration of 2
to 5 seconds might also provide. (2) Expiration phase was started
passively with the release of the nose-closure, which could be further
facilitated with simultaneous mild compression of umbilical region and
release of cricoid-pressure. Above steps were performed optionally at
the rate of 5–10 cycles per minute.