Pressure/Bubbling: Is intermittent bubbling acceptable and for how long?
Consistent bubbling is important to recruit alveoli, maintain functional residual capacity (FRC), and reduce airway resistance and work of breathing, especially in the early acute phase of respiratory distress. If the bubbling stops it means that there is a pressure leak somewhere. CPAP is not a closed leak proof system. The baby cries or yawns and pressure will leak. The most common site for leak is the mouth. We recommend a chin strap to keep the mouth closed at rest. It should not be so tight as to prevent the infant from yawning or crying, but tight enough to prevent leak at rest.
