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Purpose <p>Continuous Positive Airway Pressure (CPAP) is the main treatment for patients with obstructive sleep apnoea (OSA). Hypoxemic patients with sleep-disordered breathing may require CPAP and additional low-flow oxygen. However, specific recommendations on where to attach the oxygen bleed-in connector are lacking.</p> Methods <p>This randomised cross-over trial assessed the fraction of inspired oxygen (FIO₂) in a simulated OSA patient’s lung resulting from different rates of low-flow oxygen (1, 2 and 3&#xa0;l/min) added via three different bleed-in connector locations under different levels of either fixed pressure (5, 9 and 12 cmH<sub>2</sub>O) or constant flow (5, 10 and 15&#xa0;l/min) (repeated 3x in random order). The three locations tested in a single-limb circuit with a vented full-face mask were: (1) near the CPAP mask between the mask and tubing, (2) at the tube outlet of the device, and (3) directly connected to the oxygen-port of the device.</p> Results <p>The bleed-in connector positioned near the tube outlet generally produced the highest and near the CPAP mask the lowest FiO₂. At the highest pressure and flow, FiO₂ remained more stable across the locations and oxygen flows of 1–3&#xa0;l/min, compared to lower pressure and lower flow. FiO₂ differences between locations were notably more pronounced under different flows, ranging from 0 to 22% relative change, compared to a more limited range of 0 to 8.3% under varying CPAP pressures.</p> Conclusion <p>We recommend positioning the oxygen bleed-in connector at the device tube outlet for CPAP devices without an oxygen port, particularly when using lower pressures.</p>

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Role of the oxygen supply position in the circuit during continuous positive airway pressure therapy: a randomized cross-over simulation study

  • 期刊论文

  • 发表日期：

    2026年2月7日

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  • Zoe Bousraou,
  • Lara Benning,
  • Christina Spengler,
  • Silvia Ulrich,
  • Martin Lüchinger,
  • Esther Irene Schwarz

摘要

Purpose

Continuous Positive Airway Pressure (CPAP) is the main treatment for patients with obstructive sleep apnoea (OSA). Hypoxemic patients with sleep-disordered breathing may require CPAP and additional low-flow oxygen. However, specific recommendations on where to attach the oxygen bleed-in connector are lacking.

Methods

This randomised cross-over trial assessed the fraction of inspired oxygen (FIO₂) in a simulated OSA patient’s lung resulting from different rates of low-flow oxygen (1, 2 and 3 l/min) added via three different bleed-in connector locations under different levels of either fixed pressure (5, 9 and 12 cmH2O) or constant flow (5, 10 and 15 l/min) (repeated 3x in random order). The three locations tested in a single-limb circuit with a vented full-face mask were: (1) near the CPAP mask between the mask and tubing, (2) at the tube outlet of the device, and (3) directly connected to the oxygen-port of the device.

Results

The bleed-in connector positioned near the tube outlet generally produced the highest and near the CPAP mask the lowest FiO₂. At the highest pressure and flow, FiO₂ remained more stable across the locations and oxygen flows of 1–3 l/min, compared to lower pressure and lower flow. FiO₂ differences between locations were notably more pronounced under different flows, ranging from 0 to 22% relative change, compared to a more limited range of 0 to 8.3% under varying CPAP pressures.

Conclusion

We recommend positioning the oxygen bleed-in connector at the device tube outlet for CPAP devices without an oxygen port, particularly when using lower pressures.