{"id":216362,"date":"2026-05-04T11:56:43","date_gmt":"2026-05-04T15:56:43","guid":{"rendered":"https:\/\/www.hajim.rochester.edu\/senior-design-day\/?p=216362"},"modified":"2026-05-12T08:44:04","modified_gmt":"2026-05-12T12:44:04","slug":"saving-little-noses-redesigning-the-neonatal-respiratory-support-interface","status":"publish","type":"post","link":"https:\/\/www.hajim.rochester.edu\/senior-design-day\/saving-little-noses-redesigning-the-neonatal-respiratory-support-interface\/","title":{"rendered":"Saving Little Noses: Redesigning the Neonatal Respiratory Support Interface"},"content":{"rendered":"\n

Ryan Dugan, Nika Kazumyan, Julia Rothschild, Anika Sagar<\/strong><\/p>\n\n\n\n

Abstract<\/strong><\/p>\n\n\n\n

Approximately 10% of infants born in the US require respiratory support at birth. These apparatuses cause abrasions and pressure injuries. Our interface prototype, Ledernosen<\/em>, aims to alleviate these pressure injuries, allowing less injurious long-term use of bubble CPAP (bCPAP) systems. We’ve focused on an adjustable suspension approach using wiring and flexible tubing. This allows for significant adjustment of the apparatus to improve fit on variable infant nasal geometries. We coupled this approach with a shock-absorbing prong shape, transferring pressure into the flexible silicone as opposed to the sensitive nasal tissue. We’ve verified our prototype through airflow testing coupled with computational fluid dynamics analysis. We found that our device delivers 92.3% \u00b1 2.6% of input system airflow, without significant difference from the predicate Fisher & Paykel system delivery (p>0.5). We used contact pressure testing to determine the pressure exerted at the nares, and confirmed that our device exerted less pressure than the Fisher & Paykel interface under passive and active tension of the Flexi-TrunkTM<\/sup> (p<<<0.05).<\/p>\n\n\n\n

Problem Statement<\/strong><\/p>\n\n\n\n

Current noninvasive respiratory support interfaces used to assist preterm neonatal breathing can cause extreme skin or tissue injury via excess friction and pressure. A reassessment of interface design that considers infant comfort is required to mitigate the risk of life-long facial disfigurement caused by necessary respiratory support.<\/p>\n\n\n\n

Background<\/strong><\/p>\n\n\n\n

The cycle of care for bCPAP devices begins with a diagnosis of respiratory distress syndrome (RDS) [1]. RDS affects 90% of infants born at 24 weeks and 80% of those born at 28 weeks, typically presenting soon after delivery as decreased breath sounds, nasal flaring, lethargy, and cyanosis [1]. Preterm infants are especially prone to RDS due to the underdeveloped nature of their lungs [1]. Left untreated, RDS can progress to respiratory failure within 48-72 hours [1].<\/p>\n\n\n\n

To support breathing, bCPAP provides constant positive pressure via humidity and temperature-controlled airflow. This pressure constantly assists breathing until the neonate is capable of independent respiration. BCPAP interfaces are available as nasal masks, prongs, and cannulas. Prolonged use of these interfaces creates pressure injuries because preterm neonate skin is fragile; therefore, these interfaces are alternated every 3-6 hours to offload pressure from regions of the neonate’s skin. Injury is further exacerbated by insufficient sizing or placement options to fit all nose anatomies comfortably. Frequent interventions and complicated sizing procedures can cause infant distress and compound the NICU nurses’ workload.<\/p>\n\n\n\n

Reducing the prevalence and extremity of skin injury in neonates due to required respiratory support without sacrificing pressure delivery is a major unmet clinical need in NICUs.<\/p>\n\n\n\n

Design Metrics<\/strong><\/p>\n\n\n\n

Based on literature values of pressure exerted by the Fisher & Paykel interfaces, and factors leading to infant injury, we determined the metrics in Table 1 as appropriate parameters for prototype performance evaluation:<\/p>\n\n\n\n

Feature<\/th>Target Values<\/th>Verification<\/th><\/tr><\/thead>
Pressure Loss<\/td><2.0 cmH2O<\/td>CFD<\/td><\/tr>
Nare Occlusion<\/td>\u226580%<\/td>Prong Dimensions<\/td><\/tr>
Nare Contact Pressure<\/td>45 \u00b1 15 mmHg<\/td>\n

Pressure testing on tissue-mimicking model<\/p>\n<\/td><\/tr>

Forehead Contact Pressure<\/td>50 \u00b1 20 mmHg<\/td>Pressure-sensitive film<\/mark><\/td><\/tr>
Placement Variation<\/td><15%<\/td>Fit testing with nurses<\/td><\/tr>
Sizing Variation<\/td> <30%<\/td><\/tr><\/tbody><\/table>
Table 1. Design metrics used to evaluate prototype success<\/strong><\/figcaption><\/figure>\n\n\n\n
<\/div>\n\n\n\n

Prototype Construction<\/strong><\/p>\n\n\n\n

Modeling:<\/strong> CAD modeling was used for the prongs, tubing, and primary adapter.
Resin 3D Printing:<\/strong> Used for high-speed printing of biocompatible elastic parts with intricate geometries.
Materials:<\/strong> The prongs and tubing were printed in biocompatible soft resin, whilst the tubing-Flexi-TrunkTM<\/sup> adapter was printed in biocompatible hard resin.
Assembly:<\/strong> Wire was fed through the small lumen in the tubing, allowing the tubing and wire to be bent into their proper shape. Luer locks connected the tubing to the adapter, and the prongs were stretched over the ends of the tube.<\/p>\n\n\n\n

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Ledernosen attached to Flexi-TrunkTM<\/figcaption><\/div><\/div><\/div><\/div>