The peripheral hemodynamic effects of continuous positive transpulmonary pressure breathing in neonates free from cardiorespiratory disease.

We applied continuous positive transpulmonary pressure (CPTP) by face mask to 22 spontaneously breathing infants who were free from cardiorespiratory disease, and measured resultant changes in peak esophageal pressure (Pes) and peripheral perfusion (Q1). We measured Pes by balloon and transducer, and Q1 by venous occlusion plethysmography with a mercury-in-rubber strain gauge. Application of 7.6 cm H2O CPTP led to a 13% decrease in Q1 (paired t-test=2.39; P less than .02). Thirty-two percent of the applied CPTP was detected as a change in Pes. The biological significance of a 13% decrease in peripheral perfusion is probably minimal.