Noise Produced by Neonatal Ventilators Inside and Outside of the Incubators

• Published in: Respiratory care Vol. 68; no. 12; p. 1693
• Main Authors: Bergez, Lea, Jourdain, Gilles, De Luca, Daniele
• Format: Journal Article
• Language: English
• Published: United States 01.12.2023
• Subjects: High-Frequency Ventilation; Humans; Incubators; Infant, Newborn; Lung; Respiration, Artificial; Ventilators, Mechanical; NICU; neonate; respiratory support; safety; sound; ventilation
• ISSN: 1943-3654
• DOI: 10.4187/respcare.10989

Insufficient data are available about the noise produced by modern neonatal ventilators. We aimed to measure their noise under different ventilatory modes and parameters. This was a bench study measuring the noise produced by 9 neonatal ventilators set in conventional or high-frequency oscillatory ventilation (HFOV), nasal mask-delivered CPAP with variable- or continuous-flow configuration, or bi-level positive airway pressure (considered as noninvasive ventilation [NIV]). Conventional ventilation and HFOV were tested in 2 distinct settings with moderate or higher parameters. Sound measurements were performed inside and outside an incubator mimicking the clinical setting and using a high-end meter meeting the international ISO 226:2003 standard. Four ventilators remained below the internationally recommended safety threshold but only for measurements outside the incubator. Conventional ventilation (49.1 [3.4] dBA) and HFOV (56.3 [5.2] dBA) were the least and most noisy respiratory support technique, respectively. Noise was greater inside than outside the incubators ( < .0001) and different between the ventilators ( < .0001); better results were achieved by Servo-u and Fabian family devices for conventional ventilation; by fabian HFO for HFOV; and by Servo-u, VN500, and fabian family devices for CPAP and NIV. Noise levels were similar when using moderate or higher parameters in conventional ventilation ( = .81) and in HFOV ( = .45). Modern ventilators often produce relevant noise, independent of the respiratory support modality, with acceptable noise levels being measured only outside the incubator. Better results were achieved with Servo-u, VN500, and Fabian family devices.