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Boussignac CPAP
Just breathe
 What is Boussignac CPAP ?

Boussignac CPAP is a Non Invasive Ventilation (NIV) device generating Continuous

Positive Airway Pressure (CPAP).

Oxygen supply
Oxygen molecules arrive Oxygen acceleration
in a circular chamber from which
The oxygen molecules are accelerated
4 micro-capillaries exit
as they pass through the 4 micro-capillaries

Open to Zone of
atmosphere Turbulence

Creation of a virtual valve

The oxygen molecules collide,
generating turbulence which transforms the energy
into pressure

Pressure in the virtual

valve directly depends When you increase the flow rate,
you increase the pressure
on the flow rate of gas
When you decrease the flow rate,
you decrease the pressure

How does Boussignac CPAP work?

 he operating principle of Boussignac CPAP is simple as it is based on the creation of a

•T
virtual valve.

•T
 he pressure level obtained at this virtual valve depends on the gas flow rate supplied
to the device. When you increase the flow rate, you increase the pressure. When you
decrease the flow rate, you decrease the pressure.

•B
 oussignac CPAP is an open system and works without a mechanical valve. Thus,
it adapts continuously to the medical treatment and to the patient’s physiology, with
optimum safety concerning the pressures generated.

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 Boussignac CPAP
What are the indications for Boussignac
CPAP ?
• Pre-hospital & and Intra-Hospital Emergency Department Treatment
Main indication:
Acute Cardiogenic Pulmonary Edema (ACPE): (6) Willem Dieperink et al - BMC
Cardiovascular Disorders 2007
• Application of CPAP: 7.5 to 10 cmH2O

Other clinical indications:

Conscious drowned person: (7) Dottorini M, et al - Chest. 1996
Acute severe asthma: Boussignac CPAP can be used in conjunction with
nebulization: (9) Laurent Brochard et al - Respiratory Care. Oct. 2011 (10) Service d’Aide
Médicale d’Urgence (SAMU) de Lille: Protocole d’utilisation de la CPAP de Boussignac avec
nébuliseur. 14 mars 2007

Proven benefits of Boussignac CPAP

• High FiO2
• Rapid hypoxia correction with an increase of SpO2
• Rapid correction of ACPE’s clinical signs
• Patient’s tolerance to an open system

• Intra-hospital treatment
Operating room
Bariatric surgery, cardiac surgery, thoraco-abdominal surgery: (12)Wong D., et al - 2011.
Can J Anesth
Preoperative: pre-oxygenation : (11)Delay J.M., Jaber S. - Presse médicale 2012
Extubation with positive pressure
Postoperative: immediately after extubation: (13)Neligan P., et al. - 2009. Anesthesiology
Intensive care unit and resuscitation
Post-resuscitation: stabilization and weaning after extubation: (14)Dieperink W, et al.
- 2008. Respiration
Fiberoptic bronchoscopy in hypoxemic patients: (16) Jaber S., et al - Am J Resp Crit
Care Med Vol.162, 2000

Paediatrics
Infant bronchiolitis: (17) Fleming P.F., et al. - 2012. J Paediatr Child Health

Proven benefits of Boussignac CPAP

• Alveolar recruitment
• Prevention of atelectasis
• Improved lung volume
• Reduced risk of reintubation
• Decreased length of in-patient hospital stay
• Proven decreased rate of ventilator associated pneumonia and duration of oxygen
requirement without prolonging the hospital stay

3
 What are the features of
a good CPAP device?
cmH2O
12
11
10
DELTA P WOB
9
8 Exp. CPAP
7 Insp. 7.5 cmH2O
6
5
4
3
2 DELTA P
1
Spontaneous 0 Atmospheric
ventilation 0 1 2 3 4 5 6 7 8 9 10 11 12 pressure
Time

•T
 he Work-of-Breathing (WOB) needs to be reduced for the patient:
Boussignac CPAP decreases the WOB
The WOB is the expenditure of energy required to inspire air in the lungs.
The Delta P is the difference between inspiratory pressure and expiratory pressure.

Boussignac CPAP

Competitor A Competitor B

Expiratory work - Pressure (Tracheal) [cmH2O]

CPAP level - Pressure (Airway) [cmH2O]
Inspiratory work - Pressure (Oesophagus ) [cmH2O]

(1) Valero P., Khoury A., et al. Poster. SRLF-2013

• According to the above schematics, Boussignac CPAP was reported to have the
same performances as complex capital equipment respiratory devices and has the
advantage of having a stable CPAP level.

4
 Boussignac CPAP
Boussignac CPAP is...

Safe Effective
• Open System: if necessary the patient can • Decreases the WOB
breathe atmospheric air and thus constantly • F low rate of gas available for inspiration
breathe the required volume of gas is 280 to 320 l/min
• S pontaneous ventilation is possible even if the •T  he difference between inspiratory
gas flow stops pressure and expiratory pressure (Delta
• No mechanical parts P) is only 1.5 +/- 0.2 cmH2O (8)
• Precise control of pressures generated with • Regulation of inspired FiO2
specific manometer
• No risk of barotrauma / volotrauma: the
pressure in the lungs cannot be superior to
the one in the CPAP valve thanks to open sys-
tem
• No risk of hypoventilation

Easy to use
• Light
• User-friendly
•M  ucus suctioning is possible without
interruption of the treatment
• Possibility to connect a nebulizer
•R  egulation of FiO2 with an attachable ring

Boussignac CPAP Features:

•P  ressure variation in the airways during respiratory cycle is near 1 cmH2O, irrespective
of the CPAP level access chosen
•A irways remain accessible for any other medical intervention (aspiration, bronchos-
copy…etc)
•C  PAP level is not altered and medical interventions can be applied without any disrup-
tion of the treatment
• Peak flow rate is high, thus reducing the WOB
• In practice: clinical signs of hypoxia are rapidly reduced and O2 saturation increases
rapidly

5
 Boussignac CPAP
What are the features and benefits?

No risk of
misconnection

Supplementary port
Allows pressure
measurement, EtCO2
monitoring or additional
oxygen or air delivery

Boussignac CPAP and Nebulization

A specific nebulizer fitted with a separate
oxygen extension tube, allows an optimum
flow rate (6l/min) for drug particles
between 2 to 4 μm ensuring a perfect
broncho-alveolar spread.
FiO2 ring
Nebulizer

6
 Boussignac CPAP

Integral O2 tube
With international colour
coding for O2 delivery

Printed tube
Clearly marked tubing
for improved safety

Special « star » shaped O2 tube

Reduces the risk of tube kinking and the
associated cessation of gas delivery

This device reduces the noise

by 6 decibels. With the noise
reducer Boussignac CPAP now
reaches a level of approximatively
69 decibels (=to shower running
70 dcbls). This accessory is
optimum for intra-hospital use.
Noise reducer

7
 Product range and ordering information

Boussignac CPAP
CPAP & manometer connector code 5570.13

Single use accessories

Manometer connector code 5558.053 / 5558.203

E.T. Tube connector code 555.01

vyconnector (Y connector) code 884.06

Nebulizer code 5569.01

FiO2 ring (angle) code 5566.01

FiO2 ring (straight) code 5566.02

Noise Reduction Device code 5558.91

Mask and Harness

Mask (size 4) ≈ S code 5557.45

Mask (size 5) ≈ M code 5557.55

Mask (size 6) ≈ L code 5557.65

Silicone fixation harness code 5559.01

Fabric fixation harness code 5559.03

Reusable accessories
O2 Flowmeter (Afnor connection) code 5563.02

O2 Flowmeter (BSI connection) code 5563.41

O2 Flowmeter (DIN connection) code 5563.42

O2 Flowmeter (Nordic connection) code 5563.44

Manometer code 527.01

Air flowmeter (Afnor connection) code 5563.01

Air flowmeter (BSI connection) code 5563.31

Air flowmeter (DIN connection) code 5563.32

Air flowmeter (Nordic connection) code 5563.34

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 Boussignac CPAP

Emergency CPAP kit contents

2 x CPAP & 2 x Manometer connector code 5570.13
1 Mask (size 4) ≈ S code 5557.45
1 Mask (size 5) ≈ M code 5557.55
1 Mask (size 6) ≈ L code 5567.65
1 Harness code 5559.01
1 O2 Flowmeter
1 Manometer code 527.01
1 x 20ml syringe
1 nebulizer code 5569.01
1 FiO2 ring code 5566.01

Emergency CPAP kit code

code 5562.802 (with Afnor flowmeter)
code 5562.841 (with BSI flowmeter)
code 5562.842 (with DIN flowmeter)
code 5562.700 (without flowmeter)

1 CPAP
1 mask code 5571.303/403/503/603 (scented mask)
1 manometer connector code 5571.300/400/500/600 (odourless mask)
1 nebulizer + T piece
CPAP set 1 CPAP
with 1 mask
1 manometer connector code 5572.303/403/503/603
nebulizer 1 nebulizer + T piece
1 harness
1 CPAP
code 5577.013
1 nebulizer + T piece

1 CPAP
1 mask code 5561.303/403/503/603
CPAP set 1 manometer connector

without 1 CPAP
1 Silicone harness
nebulizer 1 mask
code 5562.303/403/503/603
1 manometer connector

9
 References
(1) Valero P., Khoury A, et al. Comparison between 3 devices delivering continuous Positive Airway Pressure
(CPAP). Poster. SRLF-2013.
(2) Richard JC, Cordioli RL, Brochard L, et al. Testing the Boussignac CPAP system on an active bench
model simulating spontaneous ventilation and comparing its efficacy and resistive properties to other CPAP
systems. Laboratory University Hospital, Geneva.
(3) Templier F., et al. Boussignac continuous positive airway pressure system: practical use in a prehospital
medical care unit. 2003. Eur J Emerg Med 10(2): 87-93.
(4) Mattu A. Lawner B. Management of congestive heart failure. Heart Fail Clin. 2009 : 19-24.
(5) Leman P., et al. Simple lightweight disposable continuous positive airways pressure mask to effectively
treat acute pulmonary edema. Emerg Med Australia 17 (3): 224-230.
(6) Willem Dieperink, Iwan Van der Horst, et al. Boussignac continuous positive airway pressure for the
management of acute cardiogenic pulmonary edema. BMC Cardiovascular Disorders 2007, 7: 40.
(7) Dottorini M, et al. Nasal-continuous positive airway pressure in the treatment of near-drowning in
fresh-water. Chest. 1996 ; 110 : 1122-1124.
(8) M. Chinellato, A.C. Astolfi, L. Aigle, E. Chinellato. Œdème aigu du poumon d’immersion. Ann. Fr. Med.
Urgence (2015) 5 : 187-188.
(9) Laurent Brochard, Bernard Maitre, et al. Aerosol delivery with the Boussignac CPAP device. Respiratory
Care. Oct. 2011.
(10) Service d’Aide Médicale d’Urgence (SAMU) de Lille: Protocole d’utilisation de la CPAP de Boussignac
avec nébuliseur. 14 mars 2007.
(11) Delay J.M., Jaber S. Respiratory preparation before surgery in patients with chronic respiratory failure.
Presse médicale 2012. 41 : 225-233.
(12) Wong D., et al. A comparison between the Boussignac continuous positive airway pressure mask and
the venturi mask in terms of improvement in the Pa02/FiO2 ratio in morbidly obese patients undergoing
bariatric surgery. 2011. Can J Anesth. 58 (6) : 532-539.
(13)Neligan P., et al. Continuous positive airway pressure via the Boussignac system immediately after extu-
bation improves lung function in morbidly obese patients with obstructive sleep apnea undergoing laparos-
copic bariatric surgery. 2009. Anesthesiology 110 (4) : 878-884.
(14)Dieperink W, et al. Boussignac continuous positive airway pressure for weaning with tracheostomy
tubes. 2008. Respiration 75 (4) : 427-431.
(15) Belenguer-Muncharaz, A, et al. Non Invasive Ventilation in severe pneumonia due to H1N1 virus. Med
Intensiva 2011 35 (8): 470-477.
(16) Maitre b, jaber s, Maggiore s.m, bergot e, richard j.c, Bakthiari h, housset b, Boussignac g, brochard
l, Unité de Pneumologie, Service de Soins Intensifs et Unité INSERM U 492, Hôpital H. Mondor, AP-HP,
Université Paris 12 - Créteil (94) France - Continuous Positive Airway Pressure during Fiberoptic Bronchos-
copy in Hypoxemic Patients - Am J Resp Crit Care Med Vol.162. pp 1063-1067, 2000.
(17) Fleming P.F., et al. Use of continuous positive airway pressure during stabilisation and infants with sus-
pected bronchiolitis. 2012. J Paediatr Child Health.

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 Boussignac CPAP
Notes

11
 ANAESTHESIA EMERGENCY
DB RESP 16 337 E - 10/17

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